n 



INTRODUCTORY LECTURES 

AND 

ADDRESSES, 

ON 

MEDICAL SUBJECTS, 

DELIVERED 

CHIEFLY BEFORE THE MEDICAL CLASSES 

OP THE 

UNIVERSITY OF PENNSYLVANIA, 






BY 




GEORGE B. WOOD, M.D., LL.D., 

PRESIDENT OF THE AMERICAN PHILOSOPHICAL SOCIETY; PRESIDENT OF THE COLLEGE OF PHYSICIANS 

OF PHILADELPHIA; PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE, AND 

OF CLINICAL MEDICINE, IN THE UNIVERSITY OF PENNSYLVANIA, ETC. 



PHILADELPHIA : 

J. B. LIPPINCOTT & CO, 

1859. 



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Entered, according to the Act of Congress, in the year 1859, by 
GEORGE B. WOOD, M.D., 
In the Clerk's Office of the District Court of the United States in and 
for the Eastern District of Pennsylvania. 



TO THE 

MEDICAL GRADUATES 
OF THE 

UNIVERSITY OF PENNSYLVANIA, 

FROM THE SPRING OF 1836 TO THAT OF 1860, 

INCLUSIVE, 

BEFORE WHOM WERE DELIVERED, 

AND IN WHOSE BEHALF WERE PREPARED, 

MOST OF THE FOLLOWING DISCOURSES, 

THIS YOLUME 

IS INSCRIBED, AS A MEMORIAL 

OF THE MANY AGREEABLE, 

AND, MAY I NOT SAY, PROFITABLE HOURS, 

THEY AND I HAVE SPENT TOGETHER, 

AMD OF THE AFFECTIONATE INTEREST WITH WHICH I CONTINUE, 

AND, SO LONG AS LIFE MAY LAST, . 

SHALL EVER CONTINUE TO REGARD THEM. 

GEO. B. WOOD. 



PREFACE. 



Being about to withdraw from scholastic medical teaching, the author 
conceives that this may be a proper occasion for publishing, in a con- 
nected form, the introductory lectures and addresses, relating to medi- 
cine, which he has at various times delivered. Most of them have been 
already printed separately by the several classes or societies before 
whom they were respectively read; but some of them now appear in 
print for the first time. Eepresenting, as they do, the views and senti- 
ments of one long devoted to the medical profession, and compelled, 
by the necessities of his position, to observe, investigate, and reflect 
upon the concerns of that profession in all its different relations, scien- 
tific, practical, ethical, and historical, they can scarcely fail to contain 
lessons, which may be more or less useful to the student and young 
practitioner. This consideration may, perhaps, be received as a suffi- 
cient excuse for their publication; but the author confesses that he has 
also other views. He wishes to bring himself again to the memory of 
the many physicians, some of them now no longer young, who have 
listened to his instructions during their years of pupilage, and to leave 
with them a memento, by which, when he shall be no more personally 
among them, they may now and then recall him to mind, with kindly 
recollections of former intercourse. 

Though the subjects are in a greater or less degree discursive, yet the 
discourses are so related among themselves, that they may be divided 
into groups, each having a certain unity of character or purpose ; and 
the reader will notice that they have been thus arranged in the follow- 
ing collection. The author has occasionally added foot-notes, when the 
lapse of years since their delivery has been attended with changes, which 
render the statements in the text not applicable to the present time, and 

w 



VI PREFACE. 

when misapprehensions might occur without such a precaution. He 
has only further to observe that all the discourses have a medical bear- 
ing, that most of them were delivered to audiences exclusively medical, 
and that, consequently, they are especially addressed to the sympathies 
and wants of his own profession. In this light he wishes them to be 
viewed; and, should others than those for whom they are intended 
happen to glance over them, he hopes they may bear in mind that ob- 
jects look very differently according to the medium through which they 
are seen, and thus be disposed, if the tints be not always such as are 
most natural and agreeable to their eyes, to ascribe the result, in some 
measure at least, to this cause. Of the friendly dispositions of his pro- 
fessional brethren he has received too many proofs, to allow him to have 
any misgivings on this score ; and he, therefore, trusts the book to the 
tribunal of their opinion, with every confidence that it will be kindly 
judged. 

Philadelphia, December 21st, 1859. 



TABLE OF CONTENTS. 



I. — Pharmaceutical Addresses. 

1. Address to the Members of the Philadelphia College of Pharmacy. 

2. Address to the Graduating Class of the Philadelphia College of 

Pharmacy. 

II. — Lectures Introductory to the Course on Materia Medica and Phar- 
macy in the University of Pennsylvania. 

1. History of Materia Medica. 

2. History of Materia Medica in the United States. 

3. Importance of Materia Medica. 

4. Abuses to which the Materia Medica is liable. 

5. Mental Agency in the Treatment of Disease. 

6. On the Choice of Medicines. 

III. — Lectures Introductory to the Course on the Theory and Practice of 
Medicine in the University of Pennsylvania. 

1. The Theory and Practice of Medicine. 

2. Requisites in the Study of Medicine. 

3. Character and Objects of the Medical Profession. 

4. Scope of the Practice of Medicine. 

IV. — Introductory Lectures giving the Results of Professional Observation 
Abroad. 

1. The Medical Profession in Great Britain. 

2. The Medical Profession on the Continent of Europe. 

(vii) 



Vlll TABLE OF CONTENTS. 

V. — Addresses to the Medical Graduates of the University of Pennsyl- 
vania. 

1. Sketch of the History of the Medical Department of the Univer- 

sity of Pennsylvania. 

2. Address to the Graduating Class of April, 1841. 

3. Address to the Graduating Class of April, 1856. 

VI. — Biographical Memoirs. 

1. A Memoir of the Life and Character of Joseph Parrish, M.D., 

read before the Medical Society of Philadelphia, October 23rd, 
1840. 

2. A Memoir of Samuel George Morton, M.D., read before the Col- 

lege of Physicians of Philadelphia, November 3rd, 1852. 



PHARMACEUTICAL ADDRESSES. 



ADDRESS TO THE 
MEMBERS OF THE COLLEGE OF PHARMACY. 



DELIVERED NOVEMBER 16th, 182 J. 



Prefatory Remarks. 

The following address was delivered in the interests of the Philadel- 
phia College of Pharmacy, then a very young institution, and standing 
much in need of support. The College was founded in 1821, and imme- 
diately established a school, in which lectures were delivered on chem- 
istry and materia meclica during the winter. In the following year it 
was incorporated; and the Trustees did me the honour to elect me to 
the professorship of chemistry, on which subject I had previously been 
lecturing to a class of medical students. The institution languished at 
first; and it was in order to excite attention to its importance, and rouse 
the zeal of the druggists and pharmaceutists of the city in its favour, 
that this address was prepared. It has been among the highest gratifi- 
cations of my life, that I was able to contribute towards the expansion 
and permanent success of a school, which has been productive of much 
good, which is still in prosperous operation, and the establishment of 
which may be considered as the commencement of a new era in the phar- 
macy of the United States. 

(3) 



THE ADDRESS. 

Gentlemen op the College : — 

It may appear singular that an individual, not immediately 
connected with your profession, should so far interest himself in its 
concerns, as to request your attention to a discourse, the chief ob- 
ject of which is the promotion of your welfare. To escape the 
charge of officiousness, which might, with apparent propriety, be 
brought against me, it becomes necessary to preface the observa- 
tions I wish to offer, by a statement of my motives for offering 
them. 

The professions of medicine and pharmacy, though, in practice, 
they should always, if possible, be entirely distinct, have neverthe- 
less a mutual dependence so complete, that the excellence and use- 
fulness of the one, are materially affected by any deficiency in the 
other. Physicians, however versed in the nature of disease, and 
skilful in its management, will inevitably meet with failures and 
disappointments, if supplied by the apothecary with inefficient me- 
dicines. As a medical practitioner, therefore, I cannot but feel a 
strong interest in the profession to which you are attached, and 
am bound to contribute, as much as lies within my power, to its 
improvement in resources, and advancement in respectability; for 
in proportion to the real standing of an apothecary in knowledge 
and character, will be the confidence with which we can rely on the 
efficacy of his preparations. 

Still it may be said, that any interference in your affairs would 
have come with better grace, and much stronger probability of suc- 
cess, from some other physician, whose more advanced age, and 
better established character, might give him a more indisputable 



PHARMACEUTICAL ADDRESSES. 

claim to your attention. But, waving the consideration that no 
one, with such qualifications, has yet come forward so decidedly, I 
may perhaps be allowed to urge, as an excuse for the course I have 
adopted, the situation to which the partial suffrages of no incon- 
siderable number of your body have appointed me, in the institu- 
tion within whose walls I now address you. As one of the teachers 
in the College of Pharmacy, anxious for its prosperity, because 
regarding it as the source of great advantages to both professions, 
and to the community in general, I feel confident that you will not 
attribute my present proceeding to improper motives ; either to a 
meddling disposition, or a vain love of display. 

Before entering on the main subject of the discourse, it may not 
be improper, in a few words, to indicate the standard both of at- 
tainment and character, at which every apothecary should aim. 
That he should have received a good general education, is neces- 
sarily implied in his acknowledged title to the rank of a gentleman. 
An acquaintance, to a certain extent, with the Latin language is 
indispensable ; for, without it, he would be utterly at a loss to 
understand the simplest medical prescription, and might often com- 
mit mistakes, the consequences of which might be irremediable, as 
regards both the health of the patient and his own reputation. 
Equally essential is an accurate knowledge of the two extensive 
sciences of chemistry and materia medica. Whether in the pre- 
paration of his own medicines, or in the formation of a correct 
judgment relative to the strength and purity of those he procures 
from others, the assistance which these sciences afford is of the 
greatest importance ; for the principles of the one are intimately 
concerned in every pharmaceutical operation, and an account of 
the sensible properties of drugs, with their effects upon the system, 
constitutes the very essence of the other. Botany and mineralogy, 
though of less importance, will, however, serve to enlarge his fund 
of useful knowledge, and procure him a profitable reputation ; 
while, by the facility they give to his researches in the two great 



G PHARMACEUTICAL ADDRESSES. 

kingdoms of vegetable and mineral nature, they will be found highly 
serviceable in his professional pursuits. 

But the possession of this knowledge is by no means sufficient. 
The apothecary is eminently a practical man. Having accumu- 
lated a sufficient store of science, he must familiarize himself with 
the various modes of applying it. To become perfectly acquainted 
with all the manipulations of pharmaceutical processes; to acquire 
that accuracy of observation which shall render the evidence of his 
senses certain, and a mistake as to the nature of articles submitted 
to his inspection next to impossible ; to be able, amidst the bustle 
of business, to dispense his medicines neatly, and without the least 
variation from the formula prescribed; these attainments, which 
are essential to merited success, require a long devotion of time, 
and a close attention to the practical duties of his profession. 
They require that he should have served a diligent apprenticeship 
to his art, under the direction of some competent instructor, and in 
a situation where opportunities for practice are constantly afforded. 

Still, however, something is wanting to the perfection of his 
character. Knowledge and practical skill must serve as the main 
spring of his actions ; but these are insufficient without the regu- 
lating influence of correct principles. The temptation to dishonest 
practices is strong in proportion to their apparent advantages, and 
their difficulty of detection; and the degree of their criminality 
may be considered as commensurate with the evil they are calcu- 
lated to produce. These conditions are peculiarly incident to the 
profession of pharmacy; for spurious or adulterated drugs must 
afford immense profits in their sale, and but a small proportion of 
purchasers are able to judge of their efficacy; while the injury 
which must result from their employment, can be measured only 
by the value we attach to our health and our existence. Thus 
strongly tempted, and thus guilty when yielding to temptation, the 
apothecary is especially called on to cultivate his moral sense ; to 
cherish in his mind correct and virtuous sentiments ; and to watch, 



PHARMACEUTICAL ADDRESSES. T 

with peculiar care, that his conduct accord with the dictates of his 
conscience. 

Such as I have described to you is the truly accomplished apoth- 
ecary ; a man of general information, of literature, of science ; inti- 
mately acquainted with the principles, and skilful in the practice 
of his peculiar art ; upright and honourable in his dealings ; a man 
whom all who know him must esteem, and who will necessarily hold 
a most respectable station in every community, where rank is at all 
the criterion or the reward of merit. As a profession is generally 
exalted in proportion to the reputation of its members, such a man 
will elevate with himself the whole body to which he belongs. How 
grateful to the best feelings of his nature, must be the consciousness 
of this truth ! how powerful and honourable the motive which it 
offers to strong and continued exertion for individual improve- 
ment ! 

But such is the constitution of human nature, that whatever, 
even with a view to our own good, calls upon us to overcome our 
habits of negligence, and natural indisposition to labour, unless the 
advantages to be derived are manifest and immediate, is apt to 
appear chimerical in our eyes, the result of wild speculation, not of 
sober reflection ; — or, even if the propriety of the call be undis- 
puted, we are too often inclined to prefer present ease and gratifi- 
cation, to an obedience which would involve us in much painful 
exertion and self-denial. 

I am sure you would accuse me of a base attempt at adulation, 
were I to exempt the members of the pharmaceutical profession 
from this general reproach. Though the apothecaries of Philadel- 
phia have certainly outstripped those of any other part of the Ame- 
rican continent in the race of improvement; yet even here, the most 
partial of us will allow, that the goal is far distant. Instances are 
not wanting of extensive general information, and great scientific 
attainment ; and the reputation of the profession for knowledge, 
skill, and character is highly respectable : but a wider diffusion, 



8 PHARMACEUTICAL ADDRESSES. 

and more accurate knowledge of those sciences to which I have 
before alluded, will be admitted to be desirable ; and greater skill 
and strictness in the practical management, by insuring to the pur- 
chaser the best possible preparations, and to the physician an exact 
compliance with his directions, will have a most beneficial influence 
on the general credit of the art, and the private advantage of its 
members. It becomes, therefore, a matter of no little importance, 
to discover and adopt some comprehensive system, by which, at the 
same time, stronger motives and more extensive means of improve- 
ment shall be afforded to the student, and a controlling and regu- 
lating influence exerted over the whole profession. 

A strong and general sense of the usefulness, if not the necessity 
of such a system, has already induced the apothecaries of this city, 
with a spirit which does them honour, to unite their exertions for 
the establishment of a college ; — the first attempt of the kind made 
on this side of the Atlantic. That an institution of this nature, pro- 
perly regulated and supported, is calculated to contribute greatly 
to the attainment of the ends proposed, will be admitted by all who 
can be induced to examine the subject coolly, and with candour. 
My principal object, in the present address, is to call your atten- 
tion to the College already established. Most of you are not igno- 
rant that it stands in need of assistance ; and, if I should be so for- 
tunate as to impress you with a conviction, that great advantages 
must result from its successful operation, and that your honour as 
a body would suffer by its fall, I am confident that your zealous 
efforts will not be wanting, to augment its strength, and infuse 
increased vigour into its movements. 

It has long been a well-established principle, that in all attempts 
to ameliorate the condition, extend the information, or exalt the 
character of large bodies of men, the greatest success may be ex- 
pected from those efforts which are directed to the rising genera- 
tion. The habits and opinions engrafted upon us in early life, and 
at first but feebly attached, become, as we advance in years, more 



PHARMACEUTICAL ADDRESSES. 9 

and more closely united with our thoughts and affections, till at 
length they seem to form a portion of ourselves, and to be al- 
most identified with our existence. They may indeed sometimes 
be torn away, as a limb may be torn from the body; but the whole 
mental constitution will be agitated to the centre, and any substi- 
tute which may be supplied, will seldom be characterized by the 
strength and symmetry of a natural growth. Besides, there is, in 
age, a great want of spirit and enterprise. The mind has settled 
down into consistency and firmness; but its elasticity is gone. 
New projects, even though their utility may be undisputed, as they 
require vigorous exertion, are received with coolness, and treated 
with neglect. Youth, on the contrary, while it is open to correct 
impressions, possesses also that vivacity of spirit which leads it to 
despise difficulties, and that energy of action which enables it to 
overcome them. 

In aiming, therefore, at the improvement of your profession, 
your eyes should especially be directed to those who are yet in 
their state of preparation. In a few years they will constitute the 
majority of your number, and will give the tone of their own char- 
acter to the whole fraternity. Make them scientific, skilful, honest, 
enlightened apothecaries, and you will have done more than could 
be effected by any other means, towards the advancement of your 
art in respectability and importance. For the accomplishment of 
this purpose, I know of no instrument so effectual as a collegiate 
institution, properly organized and supported. 

To give full efficiency to such an institution, two great objects 
should always be held in view ; the one, to provide competent means 
of instruction, the other to offer such inducements to the student as 
shall overcome his natural love of ease, and dispose him to the full 
exertion of his faculties. 

The first of these objects is most readily attainable by the estab- 
lishment of lectureships, with the auxiliary aid of a good cabinet 
of specimens, and a well- selected library. Universal experience has 



10 PHARMACEUTICAL ADDRESSES. 

adopted the mode of instruction by lectures, as decidedly the most 
appropriate for conveying scientific information. The solitary 
student, who pursues his inquiries unassisted by those better in- 
formed than himself, meets with a thousand impediments, which, if 
they do not totally discourage him, will materially retard his pro- 
gress. Almost all works of science contain much that is of little 
comparative importance, which, however, as the learner is unable 
to exercise proper discrimination, he feels himself bound to load 
upon his memory, equally with that which is most essential. In this 
way much time is lost; and facts most deserving of remembrance, 
being mingled and diluted with trifling matters, and useless specu- 
lation, make a less vivid and lasting impression on the mind. 
There are, moreover, other disadvantages which attend the unas- 
sisted student. In the commencement of his studies, he will often 
encounter passages that are to him totally unintelligible, because 
they suppose a degree of knowledge which he has not yet attained ; 
and throughout his whole course, the description of unknown sub- 
stances, and the history of phenomena with which he is not familiar, 
as they are unaided by the evidence of his senses, will present to 
his mind inadequate or erroneous conceptions. A competent lec- 
turer will have it in his power to obviate these difficulties. From 
a great mass of materials, he may select all such as bear most 
immediately on the particular subject of his lecture, rejecting what 
is of little or no interest or practical utility, and placing in a promi- 
nent point of view those facts most essential to the learner. When- 
ever any difficulty occurs, he may enter into familiar explanations 
adapted to the capacity of the most uninformed of his hearers. He 
may draw from every source appropriate illustrations, and, without 
losing sight of the main design of his course, may endeavour to 
attract and fix the attention by just and pleasing reflections, enter- 
taining anecdotes, and the beauties of an easy and spirited style. 
In the experimental sciences, the lecturer has the additional advan- 
tage of illustrating facts, and enlivening their detail, by the actual 



PHARMACEUTICAL ADDRESSES. 11 

exhibition of interesting phenomena, which, by placing the objects 
of his attention immediately before the senses of the learner, ren- 
ders the impression they make both more exact and permanent. 

There can be little difficulty in deciding upon the most appro- 
priate lectureships in a school of pharmacy. Those sciences should 
be taught which I have before mentioned as either essential or 
highly useful to the apothecary ; and materia medica and chem- 
istry, being exceedingly copious, will each afford abundant occupa- 
tion for the time and talents of one individual. To these two lecture- 
ships might be added another on botany and mineralogy, which, 
being less important, and requiring, as regards the apothecary, 
less minuteness of detail, might readily be united without imposing 
too heavy a burden on the lecturer. 

I have mentioned among the advantages of a collegiate estab- 
lishment, the facility which a good library and cabinet of specimens 
will afford to the student, in extending his knowledge, and forming 
an accurate acquaintance with the materials of his business. On 
this head I need not enlarge. Their utility is too obvious to need 
illustration; and I am happy to be informed that, in our own Col- 
lege, no inconsiderable exertions have been made for their attain- 
ment. 

Professorships on the two most important pharmaceutical sci- 
ences have also been instituted, and regular courses of lectures on 
chemistry and materia medica have been delivered for the last three 
winters. It would give me great pleasure to be able to tell you, 
that this department of the College is in an equally flourishing con- 
dition ; but most of you are aware that such an assertion would be 
an empty boast. The fact is, that, during the last winter more 
especially, the labours of the lecturers were rewarded by little 
more than the consciousness that their own share of the necessary 
duties had not been entirely neglected. The slender expenses inci- 
dent to the chemical course absorbed, within a very trifling sum, 
the whole receipts from the students of pharmacy ; and the lee- 



12 PHARMACEUTICAL ADDRESSES. 

turer was denied the pleasure he himself would have derived from 
the exhibition of more numerous experiments, by the apprehension 
of actual private loss. He might, indeed, be disposed to attribute 
this want of encouragement to his own imperfections as a lecturer; 
but surely the same reason could not be assigned for an almost 
equal desertion of his colleague. The lectures of the professor* 
of materia medica have never been accused of deficiency, either as 
to the value of the knowledge they inculcate, or as to the manner 
in which that knowledge is conveyed. We must, therefore, look 
to another source for at least a portion of this neglect; and may 
we not find it in the apathy of a great majority of the members of 
the College? Considering it a probable circumstance that their 
apathy may have arisen, in some degree, from an imperfect appre- 
ciation of the importance to an apothecary of an acquaintance with 
the sciences alluded to, or at least from a belief that a sufficient 
knowledge of them could readily be attained by private and indus- 
trious study, I attempted, early in the discourse, to impress you 
with the conviction of their great utility, and subsequently to ex- 
hibit the superior advantages of the mode of instruction by lectures. 
How far the attempt has proved successful, you are certainly the 
most competent to decide. 

It may, indeed, be urged, that even allowing the great import- 
ance to the student of the opportunities which the lectures afford 
him, still, as no immediate profit can accrue to those at present 
established in business, they cannot be expected to incur much ex- 
pense, either of time or money, for their maintenance. But sup- 
posing, for a moment, that this department of the College can be 
productive of advantage only to the future apothecary; are there 
no other motives than the mere prospect of pecuniary profit which 
can excite a man to action ? Are we not under a strong moral 

* Dr. Samuel Jackson, now Professor of the Institutes of Medicine in the 
University of Pennsylvania. 



PHARMACEUTICAL ADDRESSES. 13 

obligation, to provide for those committed to our care the most 
ample means of instruction in the art we profess to teach them ; 
and are we not, in some measure, answerable for the evils which 
must result from their deficiencies ? Can we feel no gratification 
in contributing to exalt the character, and brighten the prospects 
of our younger brethren by profession ; and thus giving to the 
profession itself an increase of consequence and respectability? 
When, moreover, we have introduced ourselves to the notice and 
applause of the world, by originating a project, noble in its objects, 
and calculated to produce the most beneficial results, is there no 
disgrace in abandoning it without an effort? in allowing it to 
perish from neglect in the very infancy of its existence ? Are not 
these considerations alone sufficient to counterbalance the pain and 
inconvenience of a little exertion, or a trifling pecuniary sacrifice ? 
I am confident that you feel them so. I am satisfied there are very 
few among you, who would not willingly contribute, to any reason- 
able extent, towards the attainment of objects so praiseworthy in 
themselves, and so closely connected with your own honour. 

It may justly be expected, that, while I am thus calling for your 
active interference in support of the school you have established, I 
should also indicate the path in which your efforts may be most suc- 
cessfully directed. At present, I allude only to the lectures. You 
will admit them to be an essential part of the institution; and you 
are aware that, without further support than they have hitherto 
obtained, they must either be entirely abandoned, or drag on a 
feeble, languid, and almost useless existence. The question then 
is, in what way can assistance be most conveniently and effectually 
afforded. Extensive pecuniary contributions, though a powerful 
agent of improvement, cannot, in the present instance, be justly 
demanded. The profession of pharmacy, like that of medicine, 
abounds more in honour than in profit. I know what it is to feel 
a spirit of enterprise cramped by the narrow bounds of a slender 
income ; to find all the resources which industry can supply, ab- 



14 PHARMACEUTICAL ADDRESSES. 

sorbed by the necessities of daily support. There are other me- 
thods by which the desired end may be more conveniently at- 
tained. Within the limits of Philadelphia, the number of young 
men who annually engage as apprentices to the apothecary's busi- 
ness is certainly sufficient, if their attendance upon the lectures 
could be secured, to afford the lecturers a compensation, not indeed 
very ample, but such as might at least prevent the discouraging 
reflection, that their labours, as regards themselves, are totally 
fruitless. To these your efforts should be directed. Your relation 
with them is of such a nature, that your opinions must be highly 
respected, and your advice influential. Endeavour to impress 
them with the belief, that their own reputation and consequent 
success will be essentially promoted by a diligent cultivation of the 
opportunities afforded by the lectures ; represent to them that no 
policy is more absurd, than, from the fear of incurring a slight ex- 
pense, to build on an insecure foundation ; and that a small sum, 
appropriated to the enlargement of their professional knowledge, 
will yield, in the future prosecution of their business, a most ample 
interest. Lay before them the prospect, so attractive to the ambi- 
tious and generous spirit of youth, of contributing by their labours 
for self-improvement, to elevate the dignity, and augment the in- 
fluence of their art ; and, having thus addressed yourselves to 
their interest and honour, appeal also to their sense of duty, by 
inculcating their strong moral obligation to enter fully prepared 
upon a business, in which it is easy to err, but difficult and often 
impossible to retrieve the consequences of error. 

Thus far, your efforts are individual and private. You may also 
contribute much to the prosperity of the school, by engrafting upon 
it such regulations, as shall offer strong motives to the young apo- 
thecary to come forward, and avail himself of its advantages. This 
brings us to the consideration of the second object, which I before 
stated to be essential in the institution of a school of pharmacy. 

In all great seminaries of learning and science, it is a practice 



PHARMACEUTICAL ADDRESSES. 15 

sanctioned by the experience of centuries, to reward, by some public 
testimonial of approbation, those students, whose industrious appli- 
cation and correct deportment have given satisfaction to their in- 
structors. The hope of distinction is, perhaps, the strongest pas- 
sion of the youthful mind ; and even that honour, which an ordinary 
degree in the arts confers, is sought after with an ardour and per- 
severance, which they who have forgotten the feelings of their earlier 
years can seldom fully appreciate. Of the thousands whom the pros- 
pect of such an honour has attracted into the paths of study, many 
have subsequently attained to great literary or scientific eminence, 
who, in all probability, without this original motive, would have 
passed through a life of contented ignorance. Of this principle in 
human nature, wise men will always avail themselves in their plans 
for its improvement. They will not only open the doors of knowl- 
edge to the young ; but will entice them to enter by the prospect 
of those trophies which exert so strong an influence over their 
imagination. The power of conferring degrees, attached to all 
collegiate institutions, may be considered almost an essential part 
of their constitution ; and the practice is certainly essential, as a 
general rule, to their successful operation. The School of Phar- 
macy cannot be regarded as an exception. I do not think I am 
going too far when I say, that it will never flourish until this prac- 
tice is adopted. 

To the young apothecary, a degree from the College would be 
desirable, not only as an honour, but also as an effective instrument 
for the promotion of his success in business. When the public are 
generally informed, as they some time undoubtedly will be, of the 
nature and designs of the institution, it cannot but happen that a 
preference will be shown for those, to whose knowledge and skill 
its testimonial can be advanced ; and, at some future period, a de- 
gree in pharmacy may be as indispensable to the apothecary, as 
that in medicine now is to the physician. In order, however, that 
the degree may have the greatest possible weight in the opinions 



16 PHARMACEUTICAL ADDRESSES. 

of men, it should never be conferred on the student, till he shall 
have passed through a certain course of study and practice united, 
and, by an examination before competent judges, shall have shown 
himself worthy of the honour. It should, moreover, be confined to 
those whose moral character is unexceptionable. 

The honour and advantage which I have hitherto stated as likely 
to accrue to the student from the adoption of this plan, are calcu- 
lated strongly to attract his attention to the College, and to entice 
him within its walls. Another very important result will be the 
promotion of increased diligence in his studies, and carefulness in 
his conduct, and consequently, his essential advancement in knowl- 
edge and respectability of character. They only can estimate the 
influence which the prospect of being submitted to a formal scru- 
tiny, preparatory to the attainment of a highly prized honour, will 
always exert over the young expectant, who are able to revert to 
their own feelings under similar circumstances. It has fallen to 
my lot to experience in myself, and to witness in others, strong 
proofs that the influence is powerful. Motives which have their 
origin in remote consequences, though these may be of the utmost 
importance, are generally less successful in rousing us to exertion, 
than others, which though comparatively trifling in their nature, 
are much more immediate in their action. It would seem as if 
mind and matter obeyed the same law of attraction; the nearer 
the attracting body, the more energetic is its influence. We all 
know that a slight temptation will lead us into error, though the 
ultimate consequences may be incalculably injurious. I shall not, 
therefore, be thought at variance with nature, when I advance the 
opinion, that, among the students of medicine, even those whose 
sentiments of honour are most lofty and determined, the necessity 
of due preparation for the trial which is to test their claims to a 
degree, has often proved a stronger incentive to active and perse- 
vering study, than all the considerations of future good or evil in 
the practice of their profession. The same effects must result from 



PHARMACEUTICAL ADDRESSES. 17 

a similar cause among the students of pharmacy; and it follows, 
therefore, that, while you contribute to the welfare of the College 
by the adoption of the plan recommended, you will also accom- 
plish, what is perhaps of still higher importance, a much greater 
individual improvement among those who are hereafter to consti- 
tute the profession, than would result from their own unstimulated 
efforts. 

Hitherto, my observations have been confined to the College as 
a school of pharmacy. The improvement of your art has been 
contemplated, not through any direct alteration in its present state, 
but by the slow and gradual, though, in the end, effectual operation 
of a well conducted professional education. In calling for your 
support, I have addressed myself much less to your personal inter- 
est, than to your moral sense, and your feelings of generosity and 
benevolence. But must we look altogether to the distant future 
for any favourable change ? Can no regulations be devised, the 
beneficial influence of which shall be speedily experienced ? Before 
the close of this address I hope to prove, not only that such regu- 
lations are not impracticable, but that the College of Pharmacy 
affords you the most ample means of carrying them into effect. 

In every business, the entrance into which is open indiscrimi- 
nately to all, a number of individuals will invariably be found, 
whose eagerness in the acquisition of wealth is never regulated by 
principles of honour and morality. Money is their god ; the pur- 
suit of gain is their religion ; honour, honesty, benevolence, even 
the safety of their own souls, are the sacrifices they are ever ready 
to offer. It is, therefore, by no means a matter of surprise, that, in 
the business of the apothecary, where, as I have before observed, 
the profit from dishonest practices is often great, and their detec- 
tion difficult, there should prevail, to no inconsiderable extent, a 
custom of adulterating drugs, and of selling as genuine many arti- 
cles which are either entirely spurious, or inefficient from age, acci- 
dent, or defect in their original preparation. Though the apothe- 



18 PHARMACEUTICAL ADDRESSES. 

caries of Philadelphia are as little concerned in such practices as 
perhaps any similar body in the world, yet instances of the most 
criminal adulteration are known to have occurred; and, with regard 
to some important medicines, the complaint of their inefficiency has 
been but too general and well founded. It is needless for me to 
reiterate an account of the evils which must result to the com- 
munity from such dishonest conduct : upon your whole class, upon 
the art itself, it is calculated to have the most injurious influence. 
An individual apothecary, by supplying adulterated or spurious 
drugs, is enabled to undersell his honest neighbours, acquires a 
credit he does not deserve, and thus attracts to himself the public 
patronage. A small degree of management is sufficient to secure 
him, at least with the great mass of his customers, from the danger 
of detection ; and, even if his fellow-dealers should be aware of his 
conduct, their complaints would be considered as the result of envy 
at his success, and regret for their own inferiority. Either to lose 
their livelihood, or to cope with him by the employment of similar 
means, becomes their only alternative ; and, to a certain extent, the 
practice of adulteration is rendered common, inferior or useless 
medicines are universally sold, and, what was at first considered a 
most criminal procedure, comes to be regarded in the light of a 
necessary evil. The baneful effects are at length experienced by 
the people and their physicians ; all confidence is lost in the general 
honesty and competence of the profession ; and its character suffers, 
in the public opinion, that degradation which it had long in reality 
undergone. Even supposing the evil to have become much less 
extensive, still, a general distrust will prevail ; and the sick, un- 
able to depend on their own judgment, will rely implicitly on the 
recommendation of their medical attendants. The current of 
patronage will thus, in all probability, be directed to a few promi- 
nent individuals, with whose character for honesty and skill the 
physician may happen to be acquainted ; while many others equally 
meritorious, but more obscure, must continue to languish on in 



PHARMACEUTICAL ADDRESSES. 19 

neglect and poverty. It is evidently, therefore, your interest to 
eradicate this evil on its first appearance ; before it shall have had 
time to strike its roots so deeply, or shoot forth its branches so 
vigorously, as to resist your utmost efforts for its destruction. In 
what way can this object be so conveniently accomplished as by 
the interposition of your representatives, the Trustees of the Col- 
lege, in their official capacity ? As the depository of your inter- 
ests, they will feel themselves bound to be watchful ; and, clothed 
with the authority of the whole profession, they will be enabled to 
act with promptness and energy. Fraudulent transactions will be 
investigated with diligence and caution; and their authors, when 
clearly detected, if no milder measures should be deemed sufficient, 
may be exposed to the indelible disgrace of public censure. Nor 
can this power, so fearful to the guilty, be exercised to the oppres- 
sion of the innocent. The judicial tribunals of his country are 
open to every one ; and he whose character has been held up to 
unmerited ignominy, has there an ample opportunity of redress. 
Even under the improbable supposition, therefore, that the majority 
of a respectable body should, from private animosity or prejudice, 
desire the persecution of an innocent individual, still, the least de- 
gree of common sense will teach them, that such a desire could 
never be indulged with safety. Their censure will necessarily be 
confined to those who may deserve it ; and the consequence of its 
proper exercise will probably be, that it will soon altogether cease 
to be deserved. 

Abuses of a different nature from those already noticed, the 
result rather of mistaken notions of convenience and propriety than 
of dishonest intention, have crept into the practice of your art, 
and are making a silent, though not unobserved progress among 
you. To point out each one of these abuses, and to display the 
extent of evil which must grow out of its encouragement, even if 
time were allowed me, does not come within the scope of my pres- 
ent design. I cannot, however, refrain from noticing one or two 



20 PHARMACEUTICAL ADDRESSES. 

circumstances, which have recently attracted considerable attention. 
I have before stated my opinion, that the professions of pharmacy 
and medicine should be distinct. So much study, and labour, and 
devotion of time are necessary for an approach to perfection in the 
knowledge and practice of either, that he who attempts to unite 
them, must, to a greater or less degree, be deficient in both. It is 
the pride of Philadelphia, to have set the example of their separa- 
tion to her sister cities of the Union ; and perhaps to this cause 
we may, in some measure, attribute her pre-eminence in medical 
reputation. The apothecary is especially bound to transgress, as 
little as possible, the limits of his own province. Not to mention 
the consideration, that the surrender of this department by physi- 
cians was a voluntary act, and therefore deserves a better return 
than an encroachment upon the portion they had reserved ; the 
good of the public, and his own ultimate interest require a close 
adherence to the duties of his proper profession. I might here 
enlarge on the evils of empirical practice ; might picture to you 
cases of pain and suffering protracted, of gentle maladies aggra- 
vated, of complaints rendered incurable, of life endangered or de- 
stroyed ; might lay before you the terrors of an alarmed conscience, 
the dread of public discovery, the agonies of self-condemnation and 
remorse ; all these consequences of an unprepared encounter with 
disease I might paint in their strongest colours, and the picture 
would not be too highly charged : but at present I wish to ad- 
vance no other dissuasive argument than the injury which would 
accrue to your own prosperity, to the solid reputation and lasting 
good of your profession. Do you suppose that medical men can 
with complacency behold their peculiar province invaded, their 
sources of livelihood cut off, the very bread taken from their 
mouths? Will they not be compelled in self-defence to make 
resistance ; and can resistance be made anywhere so effectually as 
on the ground of your adversary ? It appears evident to me that, 
were it to become customary with apothecaries to undertake the 



PHARMACEUTICAL ADDRESSES. 21 

management of diseases, physicians would almost universally recur 
to the plan they have abandoned, and, like their brethren in other 
parts of the continent, would supply their own patients with medi- 
cine. Granting that this measure might not inflict a fatal wound 
on your business, it would certainly far overbalance all the emolu- 
ments you could derive from your medical advice. There would 
be brought into competition with you a great number of respect- 
able men, whose inclination as well as power it now is to afford 
you encouragement, You are called on, therefore, both by duty 
and interest, to discourage any attempt on the part of individuals 
of your profession, to connect the practice of medicine with their 
own appropriate occupation. 

Nor is it less your policy to correct another abuse which is said 
to have made its appearance among you, derived from the same 
source of a practical connection between the pharmaceutical and 
medical arts. You have been told, and I have no doubt with 
truth, that engagements have been made between apothecaries and 
physicians, by which the former have agreed to share with the 
latter all the profits which might accrue from their prescriptions. 
We can scarcely conceive a practice, not in itself absolutely dis- 
honest, better calculated than this to lead both parties into a 
course of conduct really criminal. The physician would be strongly 
tempted to prescribe unnecessarily, and in an oppressive manner 
for his patient, while, at the same time, he would feel little disposi- 
tion to examine narrowly into the quality of the medicines fur- 
nished ; and the apothecary, in his desire to supply the deficiency 
in his profits, would find a powerful motive to lessen the original 
cost, if not by adulteration, at least by the purchase of inferior 
articles. To be efficacious, the engagement must be concealed 
from the public knowledge ; and this very secrecy affords both an in- 
ducement and a protection to fraudulent collusion. Other apoth- 
ecaries are deprived of a portion of their usual custom ; and, if the 
plan should be adopted by a considerable number, it is evident 



22 PHARMACEUTICAL ADDRESSES. 

that the remainder must be left almost destitute of support. The 
consequence, moreover, will be, either that a large portion of the 
just profits of the drug business must centre in medical men, with- 
out any sacrifice of time and labour, or risk of capital on their 
part; or that the community must suffer all the baneful effects of 
a general depreciation in the quality of those articles, upon the 
purity and efficiency of which, health, happiness, and life are often 
dependent. 

While I thus draw your attention towards the abuses of your 
art, I do not wish to be understood as advancing the opinion, that 
they have yet attained any alarming magnitude. Happily, they 
are still in the very first stage of their existence, feeble and com- 
paratively harmless. Soon, however, if fostered by your neglect, 
they will burst their shell, and, before many years, may grow up 
into a hydra, which even the strength of Hercules might be unable 
to subdue. But the general interest of a large number of people, 
particularly when it is remote and not obvious, is exceedingly 
liable to be neglected. Each individual, occupied with his own 
private and more urgent concerns, either sees not, or seeing heeds 
not the distant evils, which, though they may affect himself, involve 
equally all his associates in their consequences. Besides, it is 
seldom in the power of unconnected, individual effort, however 
strenuous it may be, to destroy the existence, or even arrest the 
progress of those abuses which have their foundation and support 
in an ill-directed eagerness for gain. To effect such a purpose, we 
must render it the particular business of a few, and devolve on 
those few our whole united influence. Here then we are enabled 
to appreciate another advantage to be derived from the establish- 
ment of the College of Pharmacy. By making it the duty of the 
Trustees to watch over the interests of the profession ; and by con- 
ferring on them the power to investigate and correct whatever 
abuses may originate among its members, you will obtain that 
union of individual activity with public strength, which is an indis- 



PHARMACEUTICAL ADDRESSES. 23 

pensable requisite to the accomplishment of any great object of 
general usefulness. Already they have evinced a disposition to 
guard with vigilance the honour and advantages of those whom 
they represent. They have raised their warning voice against one 
of those practices, which, as I before attempted to show, are preg- 
nant with evil. They have denounced, as of the most injurious 
tendency, those partnership connections with the physician, in 
which his patronage is his only capital; and have strongly recom- 
mended to all those whom their advice may influence, carefully to 
avoid entering into such engagements. At present they can go 
no further. Their authority rests, as in this country it ever must 
and should rest, upon the basis of public opinion. To render them 
fully competent as the guardians of your profession, they must ob- 
tain a standing in public estimation, which shall give to their 
decisions the authority of law. The errors of ignorance or incon- 
siderateness often require, for their correction, only to be pointed 
out; and advice from a respectable source will generally prove all- 
sufficient: but the licentiousness of unprincipled avarice can seldom 
be curbed by admonition alone. The hope or enjoyment of profit 
can, in such cases, be effectually opposed only by the certainty of 
an equal or greater loss. Hence, though the recommendation of 
the College may have great influence with men of good intentions, 
and such, I have no doubt, is the great majority of your number, 
yet, for the effectual suppression of all abuses, it must be possessed 
of power to control the most unworthy, and to render it their 
interest to act uprightly. How can this power be attained, with- 
out recourse to the odious expedient of legislative interference ? 
Only by a general conviction of its usefulness, among the members 
of your profession, among the practitioners of medicine, and among 
the people at large. 

The first and most essential step is, undoubtedly, to obtain the 
cordial co-operation of all the most respectable apothecaries. I 
have spoken, on this occasion, to very little purpose, if most of 



24 PHARMACEUTICAL ADDRESSES. 

those whom I address are not convinced of the importance of sup- 
porting the College in the exercise of a superintending vigilance; 
and conviction, in a well-constituted mind, is always followed by a 
willingness to act accordingly. You are prepared, therefore, to 
unite your influence in support of whatever measures the College 
may adopt for the general good. 

To obtain the sanction of medical men, nothing further is re- 
quisite than to make them fully acquainted with the nature and 
tendency of the Institution. Their own interest is deeply involved 
in the state of practical pharmacy; and the College will receive 
their sincere approval, and active assistance, in its efforts to estab- 
lish and maintain regulations, essential to the supply of medicines 
in their best possible condition. 

Public sentiment must ultimately derive its tone from the opinion 
of these two professional classes. Though quackery and impos- 
ture may blind a few well-informed and respectable men, and may 
impose upon many of the ignorant and simple, yet, if proper 
means be zealously employed to convey correct information, the 
great mass of citizens will, in time, be brought to see their own 
welfare concerned in the prosperity of your art, and will cheer- 
fully concur in those plans which may be formed for its promotion. 

Thus armed with the authority of the professions both of phar- 
macy and medicine, and supported by the favourable opinion of the 
community, the College will possess a degree of strength which the 
dishonest and disreputable trader will find it impossible to with- 
stand. As it is weakness which principally provokes resistance, 
this very strength will produce a quiet acquiescence in the neces- 
sary regulations ; and the College will thus be enabled, without 
interruption, to go on remedying evils, correcting abuses, pro- 
moting just and honourable dealing, and vigilantly guarding the 
interests, integrity, and respectability of the profession. 

Xo reasonable apprehension can be indulged, that the possession 
of so much power should be abused for purposes of self-aggran- 



PHARMACEUTICAL ADDRESSES. 25 

dizement ; for the influence which is founded on enlightened 
public opinion, will inevitably be lost as soon as it shall cease 
to be merited ; and, as the Trustees are a representative body, 
changeable by frequently renewed elections, they can never carry 
into effect any designs which do not meet the full approbation of 
the majority of their constituents. 

I have now spoken of two great objects, attainable by a due 
encouragement of the College of Pharmacy; the first, an im- 
proved education of the young men who design to enter the pro- 
fession ; the second, such a regulation of its general concerns as 
may afford security against corrupt practices and abuses of every 
kind, and cherish upright and honourable principles in the trans- 
action of business. I will close the address by adverting to a 
third, little inferior in importance to either of the others, and for the 
attainment of which the College affords abundant opportunities ; 
I allude to the improvement of the materials of your art. 

With respect to those of foreign growth, an inspection might be 
instituted, under the direction of the Trustees, into the qualities of 
each parcel imported, and the stamp of their approval fixed upon 
all such as present the genuine characters of strength and purity. 
Inferior, useless, or vitiated medicines from abroad would thus find 
a less ready sale, and might perhaps, in the end, be excluded in 
great measure from the market.* 

It has been ascertained that many foreign medicinal plants may 
be naturalized in our own climate, and cultivated with as great 
facility as in their native countries. With regard to such of these as 
are most active in their recent state, or require extraordinary care 

* This object has been, to a considerable degree, accomplished through 
Congressional legislation. The law for the inspection of imported drugs, 
obtained through the influence of the two professions of medicine and phar- 
macy, has effected a most happy change in the character of our drug mar- 
ket; and adulterated, or otherwise inefficient medicines, are much less used 
than at the time when this address was delivered. 



2G PHARMACEUTICAL ADDRESSES. 

in their preparation, or, from their value, are most liable to be 
adulterated, it is peculiarly important that we should introduce 
their cultivation into our own immediate neighbourhood, and thus 
be enabled to obtain them in their highest state of perfection. It 
is, moreover, highly probable, that many of our indigenous plants, 
for a supply of which we depend solely on the bounty of nature, 
might not only be increased in quantity, but might also be ma- 
terially improved in quality by a careful culture. Were the in- 
fluence of the College firmly established, and its resources suffi- 
ciently ample, it would have the power to contribute greatly to 
undertakings of this nature, both by the offer of suitable premiums, 
and still more, by securing to the successful cultivator a ready sale 
for his produce. By similar means, they might promote investiga- 
tions in practical pharmacy, and give rise perhaps to valuable dis- 
coveries, or at least great improvements in the modes of preparing 
medicines. 

Besides enhancing the value, and enlarging the supply of medi- 
cines, the College might exert its influence in promoting a perfect 
uniformity in pharmaceutical processes. It is unnecessary for me 
to inform you, that many compound preparations are kept in the 
shops, which, though they have never found a place in the Phar- 
macopoeias, are nevertheless in very extensive use, some of them 
even among medical men. It is equally unnecessary to say, that 
great diversity has prevailed in the formulas employed by different 
apothecaries for the combination of their ingredients ; and that 
consequently evils of the greatest magnitude must arise from their 
indiscriminate application to the treatment of diseases. The same 
remark, though not in an equal degree, will apply to many of the 
regular pharmaceutical preparations. As no standard Pharma- 
copoeia has been generally adopted by the profession in this city, 
each individual is left to choose, from the various European 
authorities, those processes which may best accord with his own' 
peculiar notions ; and much confusion has accordingly resulted, in 
many instances where those authorities differ. A suitable regu- 



PHARMACEUTICAL ADDRESSES. 27 

lation of this branch of jour business can be effected by no other 
plan so conveniently, and with such propriety, as by the interven- 
tion of your College, the voice of which must be considered as ex- 
pressing your collective sentiments. Nor have the Trustees been 
entirely idle. With a praiseworthy zeal for the improvement of 
their art, they have instituted inquiries into the various modes of 
preparing the patent medicines ; have selected the formulas which 
seemed best to answer the indications for which these medicines 
are usually prescribed ; and have recommended their general adop- 
tion to the members of the College. If properly supported, they 
will soon be able to proceed much further. In connection with 
the medical faculty, and with similar institutions to their own, 
either now in existence, or which may hereafter be established 
through the United States, they may enter upon the great work of 
forming a National Pharmacopoeia. If left entirely in the hands 
of practical physicians, such an undertaking must almost neces- 
sarily prove abortive. A minute and experimental knowledge, 
derived from long experience in pharmaceutical operations, is not 
less essential to its success, than an acquaintance with the remedial 
effects of medicines ; and this knowledge can be found only among 
the members of your profession. The College of Pharmacy affords 
decidedly the most convenient means of concentrating your efforts, 
and to its interference, therefore, we must look for -the accomplish- 
ment of an object, which yields little in importance to any other 
connected with the healing art. Should an American Pharma- 
copoeia, so constructed as to meet with general approbation, be one 
of the results of your labours and sacrifices in founding and main- 
taining this Institution, you will have gained the merited reputa- 
tion of conferring on your own profession, on the profession of 
medicine, on the country of which you are citizens, a great and 
permanent benefit.* 

* The U. S. Pharmacopoeia of 1820 was not generally recognized. But, 
soon after this address was delivered, a series of laborious investigations 



28 PHARMACEUTICAL ADDRESSES. 

Time is not allowed me to proceed further in my observations ; 
nor, were the opportunity afforded, am I aware that I could offer 
any stronger inducements than have already been presented, for 
your support of that cause, as the advocate of which I have this 
evening stood before you. Your individual honour and interest; 
the future good of those committed, for their instruction, to your 
superintending care; the permanent usefulness, reputation, and 
prosperity of your profession ; the health, comfort, and safety of 
your fellow-citizens ; these are objects in the pursuit of which, if 
you find no incentive to exertion, I know not by what motive I 
can address you with any possibility of success. 

But I am confident that you require no further incitement. You 
cannot but feel the importance of those purposes which your assist- 
ance to the College will enable it to fulfil; nor can you be insen- 
sible to the disgrace, which its failure, from your neglect, would 
indelibly attach to your name and vocation. That in the populous, 
wealthy, and public-spirited City of Philadelphia, the very birth- 
place of American medicine and pharmacy, and still their most 
favoured residence ; that here, with every encouragement which an 
enlightened population, and an influential medical faculty can offer, 
more than one hundred apothecaries should, by their united efforts, 
be unable, or, from an unaccountable apathy, neglect to maintain 
an institution, combining so many advantages as a well-regulated 
College of Pharmacy must do, is a supposition too derogatory to 
the character of your profession, too humiliating to our pride as 
citizens, to be allowed one moment's indulgence. With great 



was set on foot, under the auspices of the College of Physicians of Philadel- 
phia, which resulted in a revision of that work, such as, when the edition of 
1830 was published, rendered it acceptable to the professions of medicine and 
pharmacy. Since that time, it has undergone two revisions, in 1840 and 
1850, in which the Philadelphia College of Pharmacy, and other pharma- 
ceutical bodies rendered important aid; and it may now be considered as the 
admitted authoritative pharmaceutical code of the United States. 



PHARMACEUTICAL ADDRESSES. 29 

confidence we may anticipate, not perhaps an immediate, but 
certainly a high degree of ultimate prosperity for the Institu- 
tion. In the progress of years, it will outgrow its present sick 
and fragile condition. Strong internally by its own regulations, 
and externally by your unanimous support, it will be enabled to 
exercise over your profession an authority, equally beneficial to 
yourselves and to the community. Provided with ample means of 
instruction, and holding out strong inducements to studious appli- 
cation, it will diffuse copious and accurate knowledge among the 
apprentices to your art, and will greatly elevate your standard of 
scientific attainment. Finally, when the division of the professions 
shall have become more general, and apothecaries shall be required, 
not only in our larger towns, but in almost every village of the 
country, it may widen the sphere of its attraction far beyond the 
limits originally contemplated, and render the City of Philadelphia 
the centre of pharmaceutical, as it has long been of medical instruc- 
tion to the whole extent of the Union. 



II. 

ADDRESS TO THE GRADUATES 



OF THE 



PHILADELPHIA COLLEGE OF PHARMACY. 



DELIVERED APRTL 2nd, 1833. 



Prefatory Remarks. 
The address which follows was delivered on the occasion of the first 
public commencement in the College of Pharmacy. The degree of 
Graduate in Pharmacy had been previously conferred on a few, who had 
completed their course of study, and undergone the requisite examina- 
tion; but the numbers had never before, I believe, been sufficient to 
warrant a public demonstration. I was at the time professor of materia 
medica in the College, having been appointed to that chair in 1831, 
when it became vacant by the death of Dr. Ellis. My colleague, at the 
time, in the chair of chemistry, was Dr. Franklin Bache, now professor 
of chemistry in the Jefferson Medical College. 



THE ADDRESS. 

Young Gentlemen: — 

You have arrived at a period of your professional life, to- 
wards which your hopes and efforts have been directed for many 
years. Having complied with all the regulations of the College 
(30) 



PHARMACEUTICAL ADDRESSES. 31 

of Pharmacy, and acquitted yourselves with credit in the requisite 
examinations, you are about to receive the honours of the institu- 
tion, and to enter, under its auspices, upon the practical duties of 
your profession. 

You must be aware that your labours are not ended with this 
change of position. The goal you have attained is only the start- 
ing-point of a new career. Your future course will require, for a 
successful issue, no less application, industry, perseverance, and 
self-denial, than that which is passed. In this respect it differs, 
that you will no longer have guides to direct and encourage you. 
In the life you are about to enter, you must select your own ob- 
jects, mark out for yourselves the paths by which they are to be 
reached, rely upon your own energies in the difficulties you will 
encounter, and look to your own mental resources for comfort and 
support in the numerous discouragements, disappointments, and 
partial failures, which will inevitably attend your progress. I need 
scarcely tell you that much, very much, will depend on your first 
choice of an object, and on the general views which you may at 
first take of the prospect before you. Should your aim be low, 
and your views contracted, what can you expect but an ignoble 
result? labour with little reward, a life without honour, a death 
with no permanent recollections behind it ; your existence fruit- 
less, and your end, so far as relates to this world, the grave. If, 
on the contrary, your eye be fixed on some elevated point, if your 
spirit expand beyond the narrow limits of merely personal con- 
cerns, and embrace in its scope the general good ; what a noble 
field is open to your exertions ! what a rich harvest of honour is 
within your reach ! Every step, while it raises yourselves, may be 
attended with good to others; the approbation of your own hearts 
and the esteem of those around you may shed a happy sunshine 
over your days ; and, when your earthly race is run, you may de- 
part, not, like the bird in the air, leaving no trace behind you, but 
with the pleasing consciousness of having lived up to the dignity 



32 PHARMACEUTICAL ADDRESSES. 

of your nature, of having partially at least fulfilled the design of 
your Creator by contributing to the advancement of your race, of 
having impressed upon the condition of your profession, or the 
society in which you moved, some permanent marks of your labour 
in its cause. 

Standing, as you do, at a point of life from which so many paths 
proceed, leading to results so different, you will, perhaps, permit 
one who feels a warm interest both in your personal welfare, and 
in the general welfare of your profession, to make a few sugges- 
tions in relation to your future course, which may possibly have a 
tendency to enlighten your choice, or to confirm you in that to 
which your own judgment may have conducted you. It is not my 
design to press upon your attention those virtues requisite for 
great success in all honourable pursuits ; sobriety, industry, perse- 
verance, honesty; you are too well convinced of their importance 
to need any extraneous encouragement to their cultivation. I wish 
to point your attention to higher and more generous aims than 
mere personal profit; to the improvement, namely, of your art, 
and to the elevation of the character of your profession. It is 
happily true, that the measures you may adopt in the pursuit of 
these ends will redound also to your individual advantage, by the 
increased skill and reputation you will acquire, independently of 
the general advancement of which you will partake as members of 
the profession : but, though the weakness of our nature requires 
all possible support in our nobler enterprises from the selfish prin- 
ciple, there is, nevertheless, I believe, a feeling within us, which 
prompts to great and generous actions without the necessary ex- 
pectation of personal reward. This is found especially in the warm 
heart of youth, and, like every other, is enlarged and strengthened 
by frequent exercise. To this feeling I would appeal, and, without 
excluding less elevated motives of action, would call on you to 
exert yourselves strenuously for the improvement of your profes- 
sion, the honour of your calling, and the consequent good of the 



PHARMACEUTICAL ADDRESSES. 33 

community in general. Should you demand in what manner these 
ends may be best promoted, I would answer by referring to the 
history of your profession, and pointing to the causes which have 
operated in raising it from its former humility to its present com- 
paratively elevated position. 

The period is not very remote, when the apothecary was almost 
at the lowest extremity of that scale, which measures the relative 
respectability of occupations above mere manual labour. Engaged 
in preparing or compounding medicines according to certain fixed 
formulas, with little or no knowledge of the principles concerned 
in his operations, he could boast of superiority over the pastry- 
cook or confectioner in no other respect, than in the greater variety 
and importance of the materials of his art; and, while the nature 
of certain offices about the sick to which he was occasionally sub- 
jected exposed him to the sneers of the vulgar, the assumption of 
a character for research into the mysteries of nature, supported by 
the exhibition of reptiles and various monsters upon his shelves, 
made him the subject of ridicule with those who were aware of the 
real weakness of his pretensions. The apothecary, therefore, be- 
came the jest of the novelist and comedian ; and so little was the 
humility of his occupation compensated by pecuniary advantages, 
that he was chosen by the wits of the times as the very personifica- 
tion of poverty and leanness. 

In this country, pharmacy was at first almost universally, as it 
still is in many places, united with medicine. To do justice to the 
two occupations of the physician and apothecary was utterly im- 
possible for any man of ordinary endowments. That was, there- 
fore, neglected which was deemed of least importance; and the 
practitioner was too much in the habit of leaving the preparation 
and dispensing of medicines to his students, who necessarily knew 
little upon the subject, though, it is true not much less than him- 
self. How was it possible for pharmacy to flourish, or attain re- 
spect under these circumstances ? Overshadowed as it was by the 

3 



34 PHARMACEUTICAL ADDRESSES. 

sister profession with which it had been planted, its growth was 
mean and stunted, though still sufficient to abstract a portion of 
the nourishment, and thus restrain also the growth of its com- 
panion. No wonder that it was looked upon in a degrading light ! 
No wonder that men of education and a generous spirit were un- 
willing to place themselves behind the counter to dispense potions 
and powders, when no other qualifications were requisite for the 
task than such as are requisite for the selling of tape and bobbin. 
Even medicine was less esteemed in such an association; and 
young men of elevated views and respectable station in society 
Were not then as now seen crowding the ranks of that profession. 
That in some parts of the world, the business of the apothecary 
may not have been disreputable, and that in all parts individuals 
occasionally by their talents or conduct raised themselves above 
the mass of their associates into notice and esteem, is no proof 
that the general grade of the profession was not as low as I have 
described it; any more than the occasional incompetence of indi- 
viduals now attached to the profession, and its comparative dis- 
credit in certain countries, can be received as evidence of its want 
of respectability at the present day. 

Admitting, as every one must do, who has the least pretension 
to accurate information on the subject, that the present state of 
the profession is in many respects the reverse of its former state, 
that almost everywhere pharmacy is now respectable, and that in 
some places it has been elevated to a position calculated to reflect 
positive credit upon those engaged in it, let us briefly inquire into 
the means by which so great a change has been effected. It cer- 
tainly has not been solely in consequence of the progress of the 
world in knowledge and the arts of civilization ; for the condition 
of the profession would, in this case, bear the same relation as 
formerly to others, and, though it might have become more efficient 
in contributing to the general good, it could not have advanced in 
respectability, which may be considered as altogether relative. The 



PHARMACEUTICAL ADDRESSES. 35 

causes, therefore, which have produced its elevation must be in 
some measure peculiar; and, if ascertained and applied hereafter 
with increased energy, will promote, in a still greater degree, the 
same upward progress. 

Among the most prominent of these causes, and that which was 
the first to operate, was a dissolution of the union which originally 
existed between the two professions of medicine and pharmacy. 
It is not my intention to trace the gradual steps of this separa- 
tion ; to mark the frequently hesitating and reluctant recession of 
the physician from a source of accustomed profit, or the dispo- 
sition which the apothecary as frequently evinced to step over the 
boundary line, and harvest in the fields of practical medicine. It 
is sufficient to observe that wherever the separation is complete, 
pharmacy has assumed a position decidedly more elevated than 
formerly, and much superior to that which she at present holds 
where the separation has not been effected. I need only compare 
Great Britain and France, the former making few improvements in 
this science, and most of these through the instrumentality of phy- 
sicians, the latter sending forth discoveries in rapid succession, and 
acquiring by the labour of her pharmaceutists increased national 
fame, while she is benefiting the world. In the former, the apoth- 
ecary is half pharmaceutist and half physician, and consequently 
is good for little in either capacity ; in the latter, the two profes- 
sions are entirely distinct, and both in a condition of rapid advance- 
ment.* If we come home, and examine into the relative condition 

* It will be noticed that these remarks apply to the limes at which the 
address was delivered. The condition of things has since then very mate- 
rially changed in England. The pharmaceutists have erected themselves 
into a distinct profession, and have made rapid advances in their art; while 
there is a strong and increasing tendency in medical practitioners to throw 
off entirely the business of preparing and selling medicines. Before many 
years, it is probable that the mongrel race of apothecaries in England will 
have entirely disappeared; and the two professions of medicine and phar- 
macy be recognized as distinct. 



36 PHARMACEUTICAL ADDRESSES. 

of pharmacy in different parts of the Union, shall we not at the 
first glance fix upon our own city as pre-eminent; and where else, 
within this country, have the professions been so long divided ? 
That this cause is capable of producing the effects attributed to it, 
is almost too evident to require the support of argument. The 
pharmaceutist, while struggling to acquire a faint insight into dis- 
ease, and burdened with the responsibility of patients whose lives 
are in his hands, has his mental energies and anxieties too much 
enlisted in the practice of medicine, to be able to do justice to his 
more legitimate pursuit. Not only, therefore, are his time, atten- 
tion, and interest divided between two objects, each of which is 
sufficient to absorb the whole; but one of these objects becomes in 
his estimation of paramount importance, and throws the other com- 
paratively into shade. It almost always happens that, when me- 
dicine and pharmacy are conjoined, the latter suffers most, because 
less immediately and forcibly called into action. When, on the 
contrary, the apothecary confines himself exclusively to his own 
profession, he gives up to it his whole time, and, feeling his de- 
pendence on it for support, fortune, and reputation, is induced, if 
possessed of a spirit of enterprise and ambition, to exert himself 
to the utmost to increase its resources, and elevate its character. 
To this total separation, therefore, we may trace, as to their source, 
most of the other causes of improvement which were brought into 
operation. They were all such as sprang from the awakened ener- 
gies of the individual members of the profession. 

Out of this zeal arose the establishment of pharmaceutical 
schools, which, in all places where they have been in full opera- 
tion, have produced the most decidedly favourable effects; and, 
next to the original cause already stated, have been the instrument 
of more good in the diffusion of knowledge, the promotion of a 
spirit of enterprise and investigation, and the establishment of a 
common professional feeling, than any other that could be men- 
tioned. I appeal to every apothecary who has resided during the 



PHARMACEUTICAL ADDRESSES. 37 

last fifteen years in Philadelphia, whether this remark is not justi- 
fied by his observations of the influence of that school, in the hall 
of which we are now assembled. The apothecaries of Philadel- 
phia, in the establishment and support of the College of Pharmacy, 
have evinced an intelligence and foresight which do them great 
honour, and of which they have, as a body, already begun to reap 
the legitimate fruits, in a wider diffusion of intelligence and enter- 
prise, and a more elevated position in the social scale.* 

The professional spirit, fostered by schools and collegiate, asso- 
ciations, is one of the most efficient results of their favourable in- 
fluence. By this principle I do not mean a community of feeling 
in any particular body of men, as to measures calculated to pro- 
mote their pecuniary interests. This is almost universally preva- 
lent, and, in the illiberal character of its action, is probably pro- 
ductive of as much injury as benefit. Dividing the community into 
classes, it causes each to exert itself for the acquisition of peculiar 
advantages, at the expense of the others, and thus occasions hos- 

* Justice requires that some allusion should here be made to the services 
of a gentleman, to whom the pharmacy of this country is greatly indebted; 
I refer to Daniel B. Smith, formerly President of the Philadelphia College 
of Pharmacy. Standing among the first of the apothecaries of his time in 
literary and scientific attainment, peculiar skill in his art, and general repu- 
tation, he entered zealously into the movement which originated and sus- 
tained the College of Pharmacy; and, by his own written contributions, the 
encouragement which he extended to the efforts of younger men, and the 
measures set on foot, or ardently supported by him, for the improvement, 
in various ways, of the profession to which he was attached, he contributed, 
I think, more than any other one individual, to the impetus which has car- 
ried the pharmacy of this country to its present relatively high position. 
Should this notice reach him in his retirement, the author hopes that he 
will receive it kindly, as the testimony of one who has known him for more 
than forty years, has always esteemed him highly, and entertains a grateful 
sense of the early aid and encouragement extended by him to his own pro- 
fessional labours. 



38 PHARMACEUTICAL ADDRESSES. 

tility among neighbours, and diffuses an evil feeling, which is felt 
through all the ramifications of society. It has its foundation 
essentially in selfishness, and, under the pretense of working for 
the good of the class, is in fact directed altogether to individual 
profit. The principle to which I allude is of a different char- 
acter. It looks primarily to the honour of the calling, second- 
arily to the advancement of self. Based upon the generous emo- 
tions of the heart, it has nothing in it mean and low, and scorns 
even the attainment of its own ends by other than honourable 
means. True professional spirit prompts, not to raise the relative 
position of one's own calling by depressing that of others, but to 
effect its positive elevation by industry, enterprise, vigorous per- 
sonal effort, and careful personal deportment. It thus comes in 
aid of the disposition to raise the standard of one's own attain- 
ments and character, and, while it promotes the general good, 
promotes that of the individual in a still higher degree. Its tend- 
ency is to render every member of the profession a more indus- 
trious, a more honest, and more honourable man. 

With such causes as those I have mentioned in operation, it 
was not possible that pharmacy should remain in that state of de- 
pression, in which it existed before their development. Confined 
to their own legitimate pursuit, the apothecaries began to exert 
themselves for the improvement of its resources. Looking abroad 
into the fields of natural science, they observed much that could be 
advantageously applied to their art, and therefore turned their 
attention to the cultivation of the different branches of this kind of 
knowledge. The establishment of schools fostered habits of study, 
and, by giving a proper direction to the industry of the pupils, 
caused them to apply their time and talents efficiently, and not to 
waste them, as the uninstructed are too apt to do, in fruitless be- 
cause ill-directed efforts. A professional spirit was at length de- 
veloped. This gave renewed energy to the enterprising, instilled 
animation even into the dull, and breathed into the whole body 



PHARMACEUTICAL ADDRESSES. 39 

one common soul of life and activity. Happily the advanced state 
of those sciences which have a bearing on pharmacy, afforded to 
this newly awakened spirit materials upon which to act with ad- 
vantage. Chemistry, as the science most deeply interested in all 
the operations of the apothecary, was cultivated with peculiar zeal 
and success. Light broke upon the art from every side, and pene- 
trated even its darkest recesses. The confused mass of facts and 
absurdities which had accumulated, during ages of ignorance and 
superstition, experienced under this regenerating influence an in- 
ternal fermentation, which, separating error from truth, gradually 
threw off what was noxious and superfluous, and combined the 
remaining materials into new forms of usefulness. What had be- 
fore been merely a business or an art, began now to assume the 
dignity at the same time of a science and a liberal profession. The 
ascent of pharmacy was rapid ; and every step, while it widened her 
prospect, and brought new resources into view and action, elevated 
her also in the eyes of the world, and thus increased at once her 
usefulness and credit. To the present time she has suffered no 
intermission in her progress ; and, in some parts of Europe, she 
has gained that position of equality among other liberal pursuits, 
to which her nature entitles her, and which she had been pre- 
vented from attaining only by extraneous causes repressing her 
inherent energies. In France, her votaries are at this moment 
little inferior to those of any other profession in scientific attain- 
ment. Discoveries honourable in themselves, and of vast import- 
ance to the human race, have resulted from the labours of pharma- 
ceutists ; works of great value on different branches of the art have 
been put forth by men of the same profession ; and the names of 
apothecaries might be mentioned, which, in all that constitutes true 
honour and greatness, might stand by the side of those now highest 
in the world. 

Do not understand me as asserting that the pharmacy of this 
country has attained an equal elevation. It has, indeed, within a 



40 PHARMACEUTICAL ADDRESSES. 

few years been rapidly advancing, from the commencing operation 
of causes already alluded to ; but it is yet far behind that of conti- 
nental Europe. The field, however, is open, and there is no want 
of hands to labour. Let them be under the influence of a proper 
spirit, and the guidance of proper principles, and they will work 
out here the same results. You, young gentlemen, are among the 
labourers to whom the profession is anxiously looking for support. 
Your predecessors have done much ; but they could not accom- 
plish all. To you belongs the task of rolling on the accumulating 
ball which they have put in motion. You have seen the steps by 
which your professional brethren on the other side of the Atlantic 
have attained to eminence. I can do no better than point to their 
example, and bid you follow.* 

Let me, however, for a few minutes, recall your attention to the 
means which experience has indicated, and reason approves, as the 
most efficient. 

The first consideration which I desire particularly to impress on 
your minds is the importance of entirely abstaining from the treat- 
ment of disease. You have seen that the separation of pharmacy 
from medicine was the first and most essential step towards giving 
respectability to the former. The separation, however, has not 
been completely effected in this country. Physicians are in many 
places their own apothecaries; and, even in Philadelphia, we find a 
disposition in each profession to encroach, in individual instances, 
upon the legitimate province of the other. Am I mistaken in the 
opinion, that this disposition is much more general in the profes- 
sion to which you are attached than in that of medicine ? So long 

* It is due to the pharmaceutical profession in this country, to state that 
the anticipations, put forth in this address nearly thirty years ago, have 
been in a great degree realized. The profession now abounds in men of 
real science; many discoveries and improvements have been made by the 
pharmaceutists educated in this school; and the general standard of prac- 
tical skill and thorough knowledge has been greatly elevated. 



PHARMACEUTICAL ADDRESSES. 41 

as this continues, admitting it to be so, it will be impossible for 
pharmacy to attain that excellence in itself, and that respect in the 
eyes of the world which ought to belong to it. Independently of 
the consideration previously urged, that the distraction of time and 
attention will prevent the due cultivation both of the science and 
practice of pharmacy, there are others which should have their in- 
fluence on the mind of the apothecary. If the physician find a 
determined interference in his pursuits, diminishing the profits of 
his labour, and actually taking the bread out of his mouth, will he 
not be compelled to abandon the ground he has taken, and attempt 
to add the profits upon the medicines which he prescribes to his 
other resources ? Will he not thus necessarily contract the business 
of the apothecary, and deprive the latter, to a great extent at least, 
of the opportunity of treating disease, by directing every applicant 
for medical aid to his own establishment ? Grant that he may thus 
degrade his own profession ; but we all know that necessity will 
generally triumph over opinion ; and the most high-minded men may 
be compelled, by the prospect of starvation, to courses which they 
would not under other circumstances approve. There can, I think, 
be little doubt, from the relations which the two professions re- 
spectively bear to the sick, that, if they are brought into conflict, 
pharmacy will most essentially suffer: — how short-sighted, there- 
fore, is that course, which for the sake of a little temporary and 
doubtful pecuniary advantage, will risk the production of such a 
conflict. But this is not all. By attempting to perform offices for 
which you are not qualified by previous study, you necessarily de- 
grade yourselves and the profession to which you belong. In this 
particular instance, you incur the risk of injury to others, at the 
contemplation of which a properly regulated mind would shudder. 
What would you think of a man, who, without any acquaintance 
with medicines, should attempt to perform the office of an apothe- 
cary? Would he not run the most fearful hazard of inflicting 
serious, perhaps fatal injury upon others ? You can readily under- 



42 PHARMACEUTICAL ADDRESSES. 

stand how wholly unfit he must be for the business he has under- 
taken ; and you are all prepared to feel for him the due degree of 
contempt or repugnance. Would you not be in precisely the same 
situation in attempting to practice medicine ? Believe me that the 
studies which are calculated to make a good apothecary, give not 
the least insight into the proper mode of managing disease. To 
understand this, a knowledge of the human system both in its 
healthy and morbid conditions is absolutely essential ; and an ac- 
quaintance with medicines alone, so far from being sufficient, will 
often be even worse than useless by inducing a false confidence, 
and thus preventing the caution that one wholly unacquainted with 
the subject would feel himself bound to observe. I have no hesi- 
tation in expressing my belief, that an apothecary, who, without 
proper study, should assume the functions of a physician, would, as 
a general rule, be in greater danger of doing mischief than the most 
ignorant empiric ; as the latter, aware of his incompetence, will 
often confine himself to comparatively innocent means, and there- 
fore leave nature an opportunity of effecting a cure; while the 
former, familiar with the preparation of the dangerous instruments 
with which he is surrounded, might suppose that he knew how to 
employ them, and thus be tempted to the most hazardous experi- 
ments. If, then, you regard with little respect the individual who 
empirically practices your own profession, how must the instructed 
physician regard the apothecary, who, without suitable prepara- 
tion, attempts to practice medicine ? I am certain, my young 
friends, that you are not willing to incur this odium. Your own 
proper self-respect will secure you against the temptation, which a 
little pitiful pecuniary profit may offer. You will be too proud of 
your profession as apothecaries, to be willing to sink into mere 
quacks. Should you desire to change professions, you will enter 
the fold of medicine, not over the wall like a thief in the night, but 
by the regular and legitimate path of laborious study ; but your 
best plan is to persevere in the course which you have so reputably 



PHARMACEUTICAL ADDRESSES. 43 

commenced. Your profession is honourable. In its essential na- 
ture, there is nothing wlich should prevent it from standing on a 
footing of perfect equality, in the estimation of the world, with any 
other pursuit to which man is addicted. Be it your ambition to 
assist in placing it upon such a footing by your labours and con- 
duct. But this end, be assured, you never can attain, if you mingle 
with your proper pursuits those of other' professions having no 
essential connection with your own. 

There is another point in relation to this subject which merits 
attention. You prepare and dispense medicines according to cer- 
tain known and recognized principles. Does it also form a legiti- 
mate part of your occupation, to sell those with the composition 
and character of which you are unacquainted ; upon the purity of 
which you are unable to form an opinion ; which, for aught you 
know, may contain the most deadly poisons, and may produce the 
most injurious effects upon the health of the community ? Is it 
sufficient for your justification, that these secret nostrums have 
upon them the stamp of some ignorant knave, who claims an intui- 
tive insight into the nature of disease, and a miraculous power to 
apply the suitable remedy ? I submit it to your own sense of 
honour, whether it accords with your personal dignity to be the 
agents of empiricism ; whether your profession is not somewhat 
degraded, when she stoops to become the handmaid of impudent 
imposture. Though not one of her peculiar votaries, I esteem and 
love her too much to see her thus degraded without deep regret; 
and I cannot but hope that you will participate my feelings, and 
that by your hands those trammels will be removed, which bind 
her to so low a servitude. 

But it is not enough to confine yourselves exclusively to your 
own pursuit. You should endeavour to promote its interests by a 
diligent cultivation of all those branches of knowledge which have 
an important bearing upon its practice. You have hitherto ac- 
quired but the rudiments of the sciences that constitute the study 



44 PHARMACEUTICAL ADDRESSES. 

of pharmacy. The path has been cleared for your entrance ; but 
much patient labour will be necessary before you can penetrate all 
its recesses, and become masters of all its secrets. Even to keep 
pace with the progress of discovery, will require the devotion of 
no small portion of your attention. Having rendered yourselves 
familiar with all that is valuable of what is already known, you 
will be prepared to become candidates for fame in the career of 
discovery. Whether successful or not in gaining any high prize, 
your character as men of intelligence will be evident, and the pub- 
lic, observing in your example the connection between pharmacy 
and science, will be led to form a more elevated opinion of the art. 
There is one caution, in relation to experimental investigations, 
which I wish strongly to impress on your attention. Do not be in 
too great haste to promulgate any results you may have attained, 
which may strike you as new or interesting. It is a common fault, 
particularly in this country, to aim at speedy distinction ; to search 
for some short and easy path to fame. Men unprepared by pre- 
vious study or practice, enter at once into the course as competi- 
tors with those of the most careful training. Meeting with some 
result which appears new to them, in consequence of their own want 
of information, they proclaim it prematurely to the world, only to 
learn from the greater experience of others, that their supposed 
discovery is a well-known fact, or altogether illusion. Disap- 
pointed in their first attempt, they are apt to sink into discourage- 
ment, and to abandon a pursuit, which, under proper direction at 
first, might have conducted them to eminence, and in which assi- 
duity aud perseverance might still be rewarded with success. 

Analytical investigations of the various materials and products 
of pharmacy afford you the fairest opportunity of fruitful exertion. 
Before entering on them, however, you should be thoroughly im- 
bued with the scientific principles which have any bearing upon 
the subject. Practice in analysis is, moreover, essential, on account 
of the facility of manipulation which it affords, the accuracy it im- 



PHARMACEUTICAL ADDRESSES. 45 

parts to the perceptions, and the numerous contrivances or modifi- 
cations of the process which it may suggest for gaining the object 
in view. In order to obtain the requisite dexterity, repeat the 
detailed processes of the skilful analytical chemists of continental 
Europe ; and study carefully the observations which they have 
recorded, in relation to the various sources of failure, and to the 
means of facilitating success. Thus prepared, enter with caution 
and diligence upon the investigation of new objects, and weigh 
with the greatest care and scrupulousness the accuracy of the re- 
sults you may obtain. Your discoveries will then stand the test of 
examination, will enter into the mass of knowledge, and, if practi- 
cally important, or curious in their nature, will find a place for 
your own names in the annals of science, and contribute to exalt 
the credit of your profession, and your country. 

Something more, however, is obligatory on you than exertion in 
the acquisition and extension of knowledge. Successful labours of 
this kind, on the part of individual members of a profession, have 
undoubtedly a tendency to elevate its general standing; but this 
tendency may be effectually counteracted by the operation of other 
causes. However learned, however successful in scientific pur- 
suits, individuals may be, they cannot render their calling respect- 
able, without uniting with their other attainments the qualities 
which characterize the gentleman. These qualities, therefore, it 
becomes you to cultivate with the most sedulous care. A proper 
sense of what is due to yourselves and others, aversion from what- 
ever is mean or base, contempt even of wealth united with dis- 
honour ; these sentiments, co-operating with courtesy of manner, 
will ensure you a respect from all the better classes of society 
which will extend also to your calling. It is a false notion that 
attention to petty details of business is incompatible with gentle- 
manly feelings and habits. If the business be, as yours certainly 
is, of a nature calling for mental cultivation and scientific attain- 
ment ; if its proper exercise require, in an especial degree, upright 



46 PHARMACEUTICAL ADDRESSES. 

principles of conduct ; if it be calculated, according as it is well or 
ill conducted, to do much good or inflict much evil; it is undoubt- 
edly entitled to a place among the most respectable occupations, 
however minute and apparently trivial may be some of its offices, 
and however small may be the items in which its profits are re- 
ceived. It would be false shame that would deter from any, even 
the minutest detail of the apothecary's calling. No one is in the 
remotest degree incompatible with the cultivation of the nicest 
and noblest feelings of honour, the possession of the most elevated 
sentiments and principles, the practice of all those courtesies of 
manner, and those observances of society, which tend so much to 
soften the asperities of life, and to lend additional charms to its 
enjoyments. Without, therefore, neglecting the details of your 
business, endeavour to imbue yourselves with elevated feelings and 
principles, to regulate your deportment in all cases according to 
the nicest rules of propriety and justice, to become, in a word, all 
that ought to be included in the idea of a gentleman. Thus en- 
dowed, and thus acting, possessed at the same time of an accurate 
•knowledge of the pharmaceutical sciences, and devoting your ener- 
gies to their enlargement, what men in the community would stand 
or deserve to stand higher than yourselves ? Your example would 
extend its happy influence to those who might accompany or suc- 
ceed you in the same occupation ; the force of emulation, and the 
natural craving of the cultivated mind after further improvement, 
would urge to renewed efforts and more scrupulous care ; and, in all 
future times, your profession might exhibit, in her ampler develop- 
ment, more harmonious proportions, and loftier bearing, the inef- 
faceable marks of that life and spirit which you would have con- 
tributed to inspire. 

The observations hitherto made refer to your individual and 
separate exertions. Much may also be effected; with little addi- 
tional labour, by such a combination as will give to your actions a 
common direction, and a unison of character. The opportunity 



PHARMACEUTICAL ADDRESSES. 4*1 

for this combination is afforded by the Institution in which you 
have been educated. The College of Pharmacy invites you to 
enter freely, to partake of all her advantages, and to join with her 
in working for the public benefit. Upon you, indeed, she depends 
for the extension of her means of doing good. Receiving no assist- 
ance from the government of the country, endowed with no exclu- 
sive privileges, and resting solely for her prosperity and even exist- 
ence upon the basis of public opinion, she demands the warm and 
active support of all those concerned for the good of the body, 
whose interests she was designed especially to promote. Your 
predecessors have done their part nobly, first in establishing the 
College, aud subsequently in labouring for its maintenance through 
all the discouragements and difficulties incident to a new under- 
taking, calculated rather for future than immediate good, rather 
for the benefit of the successors of those originally concerned in it, 
than their own. You have been among those benefited. In addi- 
tion, therefore, to those public-spirited and magnanimous feelings 
which actuated the founders of the Institution, you have the sense 
of favours received to actuate you. The College has a right to 
expect your warm co-operation. She appeals to you not only as 
good citizens and honourable members of the profession, but also 
as children bound to her by filial ties ; and I doubt not that her 
call will be answered. You will enrol yourselves among her mem- 
bers, will zealously labour in sustaining her measures and enlarg- 
ing her sphere of usefulness, and, through these means, will more 
than repay, in advantages to those who may follow you, the debt 
of gratitude which you owe to your predecessors. 



LECTURES, 



INTRODUCTORY 



COURSES ON MATERIA MEDICA AND PHARMACY. 



UNIVERSITY OF PENNSYLVANIA. 



INTRODUCTORY LECTURES 

ON MATERIA MEDICA 

AND 

PHARMACY. 



Prefatory Remarks. 

The series of Introductory Lectures which follow have reference to 
the subject of Materia Medica, and were all delivered to medical classes 
in the University of Pennsylvania. They were designed to give instruc- 
tion on various points connected with this science, which could not be 
conveniently considered in the body of the annual courses. The most 
prominent of these points are 1. the general history of the Materia 
Medica, 2. its special history in the United States, 3. its character and 
importance, 4. the abuses to which it is most liable, 5. the influence of 
mental agencies in a therapeutical point of view, and 6. the principles 
which should regulate the choice of medicines. 

The lectures are not here presented exactly in the succession in which 
they were delivered, but rather in the natural order of the subjects. 
They were read at different times between the year 1835, when I was 
chosen professor of Materia Medica and Pharmacy in the University, 
and the year 1850, when I was transferred to the chair of the Practice. 
The reader will find in them observations, reflections, and opinions, 

(51) 



52 INTRODUCTORY LECTURES 

which have been the result of much experience, and of a long attention 
to the subject; and which, I cannot but hope, may have some value for 
the young medical man, who has not hitherto had opportunities equal to 
those of the author. The thoughts contained in them were not hastily 
thrown together, but were the result of mature deliberation ; and the 
lectures themselves, so far as the matter is concerned, were elaborated 
with no little care. 



LECTURE I. 



DELIVERED NOVEMBER 7th, 1S43. 



History of Materia Medica. 

I greet you all, gentlemen, most cordially. We are beginning 
a long work together. Let us join in it heart and hand. We shall 
thus not only do more, but shall have increased pleasure in what 
we do. Labour itself, when directed to a useful end, is never with- 
out its satisfaction. A sweet melody, that sleeps everywhere in 
nature, is awakened by a series even of solitary effort. But the 
music is heightened into a delightful harmony, when we touch the 
strings together and in concord. 

I need not tell you that our field of joint labour is that of ma- 
teria medica and pharmacy, or the science of pharmacology. Over 
this field let us throw a hasty glance before entering it. 

We do not require history to inform us that the origin of the 
materia medica was nearly coeval with that of disease. Bodily 
suffering and the fear of death are eager and quick-sighted search- 
ers after means of relief and safety ; and nature is seldom niggardly 
when approached with an earnestly inquiring spirit. No tribe is 
so savage as not to have its little catalogue of remedies. The 
earliest records of the human race refer incidentally to the exist- 
ence, not only of medicines, but of the art of preparing them. In 
the thirtieth chapter of the Mosaic Book of Exodus, written pro- 

(53) 



54 HISTORY OF MATERIA MEDIC A. 

bably nearly 1500 years before Christ, is the following injunction, 
"And thou shalt make it a perfume, a confection after the art of 
the apothecary." This is the first recorded notice, so far as I 
know, upon the subject of medicine and pharmacy. From other 
passages in Scripture, there is reason to believe that our art was 
cultivated, and in great esteem among the Hebrews. 

The fabulous history of the early Greeks affords evidence that 
they also had their materia medica, and held the office of the 
physician in high honour. Pausanias relates that Melampus, who 
is supposed to have lived anterior to the Trojan war, cured the 
daughters of a king of Argos of mental disorder by means of 
hellebore, and received as a reward the hand of one of his patients 
and a third of her father's kingdom; and Esculapius, who prac- 
tised the art of healing at a somewhat later period, was made a 
god after his death, and had temples erected to his honour in 
various parts of Greece. 

It is altogether probable that both the Hebrews and Greeks de- 
rived the rudiments of their materia medica from Egypt. What- 
ever knowledge, other than that revealed in the wilderness, the 
Israelites took with them into Canaan, must have been acquired 
in the country of their birth and long bondage; and the early 
legends of the Greeks point to the same land as a place of philo- 
sophic pilgrimage, where those ambitious of enlightening their 
native country deemed it necessary to pay a preliminary homage 
at the shrine of science. Melampus is said to have brought his 
medical knowledge out of Egypt ; and some have conjectured that 
Esculapius, instead of being of Grecian birth, was an Egyptian 
god adopted by the Greeks. 

The list of medicines in these remote times was extremely 
meager, consisting chiefly of substances intended for external use. 
In the cure of internal disorders, as they arose from unseen and 
mysterious influences, reliance was placed chiefly upon equally 
mysterious remedies; upon charms and sorceries, upon propitia- 



HISTORY OF MATERIA MEDICA. 55 

tory prayers, sacrifices, and gifts, which might avert some super- 
natural malice or vengeance, or secure the favourable interposition 
of some health-giving deity. 

A materia medica of this character fell naturally into the hands 
of the priesthood. Accordingly, among the early Greeks, the tem- 
ples of Esculapius were the chief resort of the sick ; and the priests 
of that god, who were also his reputed descendants, and known by 
the family name of the Asclepiadse, enjoyed an almost exclusive 
monopoly of the practice of medicine. The knowledge they pos- 
sessed was handed down, either orally or through the secret re- 
cords of their temples, for a long succession of generations, and 
must have gone on gradually accumulating, as the necessary result 
of continued observation and experiment. This knowledge was 
first made accessible to the world through the writings of Hippo- 
crates, who was himself one of the favoured family, had studied in 
the school of Cos, one of the most famous of the Esculapian tem- 
ples, and was thoroughly initiated in all the secrets of the brother- 
hood. To these writings we must have recourse in forming our 
opinion of the condition of medical science in general, and conse- 
quently of our own branch in particular, at the most flourishing 
period of Grecian civilization. 

From their contents we should not infer that materia medica 
had made very great advances. Of the substances employed little 
more is mentioned than their names ; and, from the uncertainty of 
the nomenclature, and the absence of precise description, it is im- 
possible, in most instances, to determine as to their identity with 
those now in use. Even in cases where the ancient and modern 
designations are the same or similar, it does not follow that the 
substances designated are identical ; for nothing is more common 
than the diversion of a name from its original application. There 
is, however, good reason for thinking that several medicines, which 
stand high in modern catalogues, were used in the time of Hippo- 
crates. Among them may be mentioned black hellebore, elaterium, 



5G HISTORY OF MATERIA MEDICA. 

scammony, squill, myrrh, galls, and that most invaluable of me- 
dicines, opium, for which alone, had antiquity bequeathed us no 
other gift, we should be bound to it in endless gratitude. 

From the time of Hippocrates, who died about 370 years before 
Christ, to that of Dioscorides, in the first century of our era, the 
materia medica underwent a gradual process of accumulation. It 
is probable that the medical sect denominated Empirics, which 
arose during the interval, contributed most largely to this increase. 
Sensible men were they who, in those times, could break loose from 
the trammels of speculation, and devote themselves exclusively to ob- 
servation, experiment, and close induction. A vain notion appears 
to have taken possession of the minds of men calling themselves 
philosophers, that an industrious digging in the earth after truth 
was unfit occupation for one who could soar into the loftier and 
purer region of the spiritual. In their silly pride of intellect, they 
deemed that they could fathom the depth of creative wisdom, enter 
into the counsels of omnipotence, and comprehend the principles 
of things by their own mental energy. Usurping the functions of 
deity, they made for themselves hypothetical creations, into which 
they forced the things of nature, torturing them into all sorts of 
strange shapes to suit the measures of their fancy. Medicine, 
like every other science, was infected by this insanity of speculation. 
The Dogmatical physicians, as they were called, seated securely in 
their own imaginary truths, looked out with contempt upon the 
humble labours of research. Happily, their principles have in 
modern times fallen into disrepute; and the esteem in which they 
are now held may be measured by the discredit attached to the 
very title of the sect. Dogmatism is but another name for self- 
confident ignorance. Nor, in truth, has it fared much better with 
the Empirics. This sect was founded in just principles. To ob- 
serve, to experiment, to infer carefully, and to record, such was the 
course marked out for themselves in the search of truth ; and such 
must ever be the course of those who expect to find it. But the 



HISTORY OF MATERIA MEDICA. 57 

Empirics did not carry out their own principles. While they 
sought new remedies, investigated the properties of those known, 
and tried the effect of various combination; they undervalued ana- 
tomy, neglected the study of disease, and fell into the fatal error 
of prescribing merely for a name. With their eyes fixed constantly 
on medicines, they could at length see nothing beside. Certain 
substances began to stand prominently out in their field of vision, 
and soon absorbed their whole attention and faith. Hence came 
nostrums and panaceas, and the inseparable attendance of loud 
boasting and confident promise. The scientific gave way to the 
sordid. The mysterious aid of secrecy was invoked. Fraud mingled 
in various proportion with self-deception. The stream which had 
issued pure from its fountain, became more and more contaminated 
as it pursued its downward course through the baser feelings of 
our nature, till at length it ended in the kennel. The name of 
Empiric became a badge of dishonour, a mere synonyme of quack. 
There is little doubt, however, that the sect added much to the 
resources of the materia medica ; though it remained for later 
times to make these resources available for practical good. 

It was probably during this period that the rage for multiplicity 
in the combination of medicines originated. Substances of the 
most heterogeneous character were mixed together in great num- 
bers, upon no other grounds apparently than the hope that some 
one of them might be found effective, or that, in this hap-hazard 
pharmaceutical gambling, some lucky combination might occur to 
be set off against a thousand failures. Occasionally one of these* 
luxuriant mixtures appeared to stand the test of trial, and obtained 
a more or less permanent reputation. Two of the most famous 
were the Antidote of Mithridates, so called after its supposed in- 
ventor, the celebrated king of Pontus, and the Theriac of Andro- 
machus, which originated with the physician of Nero whose name 
it bears. The former contained 54, the latter from 60 to TO ingre- 
dients. In the view of modern science, they are both in the highest 



58 HISTORY OF MATERIA MEDICA. 

degree absurd ; but they continued in great credit until a compara- 
tively recent period ; and the Theriac still encumbers and disgraces 
the national pharmacopoeia of France. 

A necessary consequence of this endless complexity of composi- 
tion was the separation, to a certain extent, of the art of preparing 
from that of prescribing medicines. Each was abundantly suffi- 
cient to give occupation to one set of men. So early as in the 
third century anterior to our era, many physicians of Alexandria, 
then the seat of a celebrated school of philosophy and medicine, 
under the patronage of the Ptolemies, are said to have devoted 
themselves exclusively to the preparation of drugs. Since that 
time, the two professions of the physician and apothecary have 
been more or less divided ; though in new countries, and in remote 
situations where the population is not dense, and not collected in 
large towns, it still happens that necessity frequently unites them 
in the same individual. Mantias, a pupil of the famous Herophilus 
of Alexandria, enjoys the credit of having composed the first phar- 
macopoeia. 

The treatise of Celsus "De medicina," written during the reign 
of Augustus, and the most classical of the Latin medical works, 
though not devoted especially to the materia medica, gives the 
names of numerous medicines, with occasional brief accounts of 
their properties and applications, and a long catalogue of recipes. 
Though richer in pharmacological information than any previous 
work now extant, it is yet very meager and indefinite. The reader 
seeks in vain for detailed and accurate description ; and the for- 
mulas given are mostly for external remedies, which are as poor in 
virtues as they are rich in the number of ingredients. 

The work of Scribonius Largus "Upon the Composition of Me- 
dicines" was written soon after that of Celsus, to which it is greatly 
inferior in style, without being superior in its pharmacology. 

The two authors mentioned treated of medicines only incident- 
ally, or in relation to their pharmaceutical preparation. Dios- 



HISTORY OF MATERIA MEDICA. 59 

corides may be considered as having composed the first regular 
treatise exclusively on materia medica. This celebrated medical 
writer was a Greek of Cilicia, in Asia Minor, and is supposed to 
have flourished in the reign of Nero. He treated, under distinct 
heads, of the plants and animals remedially employed, of the com- 
position and use of medicines, of counter-poisons, and of venomous 
animals. Not less than 600 plants are mentioned or described by 
Dioscorides, showing that our science had already become griev- 
ously burdened, far beyond the abilities of her young shoulders to 
support. His descriptions have all the imperfections of the un- 
scientific methods of his age ; so that few comparatively of the 
plants which he mentions can now be recognized, and endless con- 
troversies have arisen as to their identity with those at present 
known. His pharmacy and therapeutics are not less defective. 
How could it have been otherwise, when botany was not yet a 
science, chemistry was altogether unknown, and anatomy and phy- 
siology had scarcely burst the shell in which the rudiments of their 
future growth lay enveloped ? These sciences are the basis of me- 
dicine. How then could a durable structure be erected without 
them? All that could be expected of an ancient writer on me- 
dicines was to lay up a stock of materials for future hands to put 
together. This was done by Dioscorides beyond any preceding 
author. His work, viewed in relation to the times when he wrote, 
was a great work, though in relation to the present nearly worth- 
less. 

The Natural History of the elder Pliny, who wrote at Rome some- 
what after the time of Dioscorides, contains notices of numerous 
medicinal products ; but, as he was not a physician, most of what 
he says upon this subject was borrowed from the writings of his 
predecessors. 

We next come to Galen, perhaps the greatest medical name 
among the ancients, at least the one which has exerted most in- 
fluence upon succeeding times. Had we lived four centuries ago. 



GO BISTORT OF MATERIA MEDICA. 

and ventured to doubt the infallibility of that name, we should have 
incurred the risk of being deemed suitable objects for the pillory 
or the mad-house. There can be no doubt that this author had 
great powers and great merit. But his influence over after ages 
rested more upon the time at which he wrote, than upon the excel- 
lence of what he wrote. Born at Pergamus, in Asia Minor, in the 
year 130 of our era, and dying about the close of the second cen- 
tury, he lived at a time when the human powers, mental as well as 
physical, had, in the progress of ancient civilization, begun to ex- 
hibit the decrepitude of age. The period was fast approaching 
when man ceased to have the energy of independent thought, and 
leaned exclusively upon the strength of the past. The Roman 
Empire propped up her physical decay by the uncorrupted bodily 
vigour of the neighbouring barbarians, whom she incorporated in 
her armies. No such resource existed for mental deficiency. The 
accumulations of former ages were the sole reliance of the feeble 
senility of the Empire, as well as of the mental infancy of the cen- 
turies which succeeded its fall. Galen had great industry and 
powers of observation, with a strong inventive and imaginative 
faculty. Out of the materials which lay scattered in the works of 
preceding authors, with no little aid from his own vigorous fancy, 
he erected a system of medicine, which was faultless in the eyes of 
his contemporaries, and, standing prominently on that great eleva- 
tion which looked over thirteen centuries of declension or bar- 
barism, loomed magnificently to succeeding ages, and only began 
to grow dim when the light of reviving letters and science once 
more shone upon Europe. At present, it has fallen into utter 
ruin ; and the wonder is that a structure with so little of the 
solidity of truth, and so much of the pasteboard-work and colour- 
ing of mere imagination, should have so long withstood the ravages 
of time. When I tell you that, according to the theory of Galen, 
medicines have only the four primary properties of heat, cold, 
moisture, and dryness, and differ from each other only as they pos- 



HISTORY OF MATERIA MEDIC A. 61 

sess, or in the degree to which they possess, one, or another, or 
some combination of these properties, you will join me in admiring 
the simplicity which could receive so sheer an assumption for irre- 
fragable truth. But thus it was received; and, from the com- 
mencement of the third down to the sixteenth century, it would 
have been deemed as heretical to doubt the four qualities of Galen, 
as the equally absurd fiction of the four elements — fire, air, earth, 
and water. As nothing was detracted from the theory of Galen 
daring this long period, so little was added to his facts. Indeed, 
for a great portion of the time, Western Europe lay almost in the 
darkness of barbarism ; and, so far from any improvement upon 
the ancients being made, only some feeble phosphorescent glim- 
merings of science continued to shine, here and there, about the 
musty remnants of antique learning, preserved in the convent 
libraries. 

In the East, however, a new fountain of human energy had 
broken forth, which spread widely over the civilized world, and 
everywhere recalled a certain degree of fertility to the parched 
desert of the intellect. The successors of Mahomed no sooner 
found themselves securely seated in Bagdad, than they sought to 
beautify the rough edifice of their power with the ornaments of 
science. With the Syrian and African dominions of the Eastern 
Empire, the Arabians had seized also the treasures of Grecian 
learning, which they made available by recasting them into their 
own language. Medicine, as one of the most useful of the sciences, 
received a particular attention. The chief writers upon materia 
medica were the younger Serapion, the younger Mesue, Rhazes, 
Avicenna, Haly Abbas, and Albucasis. What they wrote, how- 
ever, was chiefly borrowed from the Greeks. A few medicines, in- 
digenous in their own country, or brought from the neighbouring 
regions of the East with which they had commercial intercourse, 
appear to have been either newly introduced by them into use, or 
at least were first made known, through their instrumentality, to 



62 HISTORY OF MATERIA MEDICA. 

modern times. The first notices of senna and nux vomica are to 
be found in the writings of the Arabians. They cultivated phar- 
macy with especial zeal, and enjoy the credit of having laid the 
foundation of chemical science. There is reason to believe that 
they were acquainted with some mineral preparations, wholly un- 
known to the ancients. Rhazes speaks of a preparation of mer- 
cury ; and it is highly probable that they were not altogether igno- 
rant of the antimonials. 

The enlightened spirit which characterized the Arabians of the 
East was carried also into Spain by its Mahomedan conquerors; 
and schools of medicine were established in the cities of Toledo, 
Murcia, and especially Cordova, which continued in existence until 
the subversion of the Moorish power in the fifteenth century. 

It was, indeed, through the Arabians that the knowledge of an- 
cient medicine began to be revived in Western Europe. The 
medical school of Salerno, in the south of Italy, which is said to 
have been established in the ninth, and continued to exist in the 
thirteenth century, owed its foundation and support to individuals 
who had been educated in Mahomedan countries. Many of the 
Crusaders who, in the East, had exchanged their religious enthu- 
siasm for admiration of Arabic science and civilization, and ac- 
quired a knowledge of the Arabic language, must have carried 
their new attainments back with them into Europe, and become 
centres here and there of a feeble illumination amidst the deep 
general darkness. The Moorish schools, moreover, in the south 
of Spain, were frequented by individuals from the Christian coun- 
tries of the North, who contributed to spread still further the 
second-hand knowledge of the Arabians. The leaven, thus intro- 
duced into various parts of Christian Europe, began to produce a 
slow working of the general mind, which required only the infusion 
of more abundant material to result in the most vigorous action. 
Such material was now poured in from the East, in consequence of 
the capture of Constantinople by the Turks in 1453, and the expa- 



HISTORY OF MATERIA MEDICA. 63 

triation of all that remained of learning and science among the de- 
generate Greeks. The fugitives, scattered over Europe, and espe- 
cially over Italy, sought a livelihood by teaching Greek, and thus 
afforded access to the riches of ancient knowledge stored away in 
that language. The works of the Grecian writers were also trans- 
lated into Latin, and, by means of the art of printing, then recently 
discovered, were rendered accessible to all who had any pretension 
to learning in those days. 

As, in the corporeal frame, excitability accumulates during sleep, 
so the long death -like repose of the human mind appears to have 
endowed it with renewed vigour ; and the materials which, in the 
hands of the worn-out Greeks, lay useless for the want of power to 
employ them, were eagerly seized by the awakened spirit of the 
West, and wrought upon with all the energy of youthful ambition 
and enterprise. Medicine received its full share of attention. It 
was soon found that the knowledge, obtained from the Arabian 
authors, was but an imperfect abstract of that now open in the 
writings of the ancient Greek physicians, and especially in those of 
Galen. The works of this author were considered as oracles. In 
the intensity of the prevailing appetite, everything which they con- 
tained was received and devoured without scruple or selection ; 
pure speculation, crude assertion, absurdities of all kinds, as well 
as sound reason and truth. 

But this could not last forever. The intellectual hunger was at 
length appeased. In many minds, satiety took the place of the 
first keen relish; new sources of excitement were demanded; and 
inquiry began to extend itself beyond the limits of authority. The 
remedies of the ancients were derived chiefly from the vegetable 
kingdom ; and the few of mineral origin employed, were applied 
for the most part to ulcers and other external affections. The 
Arabians had originated a taste for chemical research. This, it is 
true, was directed towards the discovery of the philosopher's stone 
and the elixir of life, the former of which was to convert everything 



G4 HISTORY OF MATERIA MEDICA. 

into gold, the latter to protract human existence to a thousand 
years. But the operations of the Alchemists brought to light 
numerous mineral compounds, which, though incapable of length- 
ening the natural span of life, were found useful in the relief of 
disease. The insurrectionists against authority seized upon these 
new instruments, and wielded them with a senseless and indiscrimi- 
nate vigour. Isaac of Holland and Basil Yalentine maintained 
that salt, sulphur, and mercury were the true elements of things. 
A work ascribed to the latter, under the name of "Currus triumph- 
alis Antimonii," set forth the merits of the antimonials in extrava- 
gant terms. The bold, eccentric, and visionary Paracelsus, armed 
with mercury, antimony, and opium, and clothed with an impene- 
trable mail of impudence, ran a vigorous tilt at once against disease 
and old opinions, and roused the attention of all Europe to his 
feats. Van Helmont followed with a more enlightened defence of 
chemical medicine. The advocates of the ancients struggled man- 
fully against these innovations ; and a fierce contest arose between 
the Galenists on the one side, and the Chemists on the other, which 
continued not less than a century. The latter ridiculed the inert- 
ness of the Galenical simples ; the former inveighed in unmeasured 
language against the murderous violence of the chemical prepara- 
tions. The depositories of political power sympathized with the 
supporters of authority in medicine; and at one time the use of 
chemical remedies was forbidden in France under heavy penalties. 
Common sense, however, at last prevailed; and physicians felt 
themselves at liberty to use efficacious means wherever they might 
be found. The materia medica was thus enriched by the addition 
of numerous metallic and saline preparations, some of which are at 
the present day considered among the most valuable of our re- 
medies. 

About the same period, important accessions to the materia 
meclica began to be received through the channel of geographical 
discovery. The traders to India, by the Cape of Good Hope, 



I HISTORY OF MATERIA MEDICA. 65 

brought various hitherto unknown medicinal products from the 
remote East, and rendered abundant in the markets of Europe 
others which had before reached the West, in small quantities, 
through the expensive route of Arabian and Venetian commerce. 
The discovery of America, too, laid open a vast field, which has not 
yet been completely explored or exhausted. Everything is said to 
be gigantic on this continent; our plains, our rivers, our moun- 
tains; we may add also our diseases and our remedies. For thou- 
sands of years the giant strength of Peruvian bark had been slum- 
bering in the Andes. It was now awakened ; and diseases which, 
since the creation, had been stalking, almost unresisted, with a 
desolating march over the earth, shrunk into insignificance before 
its beneficent power. Ipecacuanha, jalap, copaiba, sarsaparilla, 
guaiac, and logwood were also among the numerous contributions 
made by this continent to the general materia medica. 

Up to the seventeenth century, the condition of our science was 
that of progressive accumulation. Remedy was added to remedy ; 
the whole materia medica of Greece and Rome, swollen by Arabian 
contribution, was poured into the lap of modern Europe ; and art 
and nature were ransacked to increase the already vast and ill- 
assorted mass. There were gems in this mass ; but they only 
sparkled here and there amid the rubbish in which they were em- 
bedded. It may be instructive to throw a glance backward, and 
mark some of the sources of the useless materials which thus 
loaded the materia medica. 

In the first place, many substances inferior in virtues, or com- 
bining some noxious property with that for which they were origi- 
nally used, though superseded by the discovery of others more 
efficient and less objectionable, were retained from habit, the weight 
of authority, the affectation of science, or the difficulty, in the irra- 
tional therapeutics of the times, of conclusively ascertaining their 
real relative efficiency. 

Again, we now know well that most diseases will in the end, as 

5 



66 HISTORY OF MATERIA MEDICA. 

a general rule, terminate favourably without medicines, and not 
trafrequently even in spite of medicines. One not properly in- 
structed on this point, seeing recoveries taking place under his 
treatment, naturally ascribes the result to his medicines, though a 
closer observation, a more prolonged experience, or a better judg- 
ment might afterwards convince him that they were in fact useless, 
or worse than useless. Here has been at all times, and still con- 
tinues to be, the strong-hold of quackery, and of all other forms of 
irregular and irrational practice. "My patients get well," says 
the old woman, and the Indian Doctor, and the man of nostrums 
and panaceas, and the homceopathist, and the hydropathist, and 
the whole host of irregular prescribers, through all their ramifica- 
tions of ignorance, self-deception, cunning, and impudent fraud. 
" My patients get well," say these pretenders ; and so they often do. 
But it is because nature is wiser and kinder than the prescriber, 
who nevertheless ignorantly or unscrupulously ascribes to his nos- 
trum all the credit of the cure. Such was the origin of a large 
proportion of the inert medicines, which crowded the catalogues 
of the older pharmacopoeias. 

But there was another abundant source of the same evil. Men 
had yet not learned the wonderful influence of mental operations 
over the bodily functions in health and disease. They had not 
observed how often disorders, especially those seated in the ner- 
vous system, give way before powerful emotions, or any strong ex- 
citement of the rational or imaginative faculty. In full faith they 
gave their inert medicaments ; in full faith their patients received 
them ; and, without irreverent allusion, faith in medicine is able to 
remove mountains. It is well known that the cure of intermittent 
diseases is often effected by exciting in the mind of the patient a 
firm belief that he will miss the paroxysm. The substance em- 
ployed may have been wholly inert ; but it is nevertheless believed 
to have produced the result, and takes its rank in the materia 
medica. 






HISTORY OP MATERIA MEDICA. 67 

But if, along with faith, some other strong mental agency be 
called into operation ; the mysterious, the fearful, the horrible, the 
disgusting; anything that makes one shudder, the effect is vastly 
increased. Hence, in old times, the bones of executed criminals, 
the moss growing on a dead man's scull, animal excrement, toads, 
and snakes, and disgusting insects, and all sorts of venomous 
beasts, were supposed to possess curative powers, and therefore 
found a place in pharmacological catalogues. So common was 
this, that the apothecary did not think his shop furnished, unless 
he had in his windows a goodly show of bottled snakes and liz- 
zards. The web of spiders is even now considered an efficacious 
remedy by some practitioners; and dried vipers are retained, as 
one of the ingredients of the Theriac, in the last edition of the 
French Codex. 

Another somewhat analogous source of inert medicines existed 
in the singular doctrine of signatures, which supposed a therapeu- 
tical relation between substances endowed with certain sensible 
properties of colour, taste, and shape, and the diseases of organs 
in which these same properties were found or imagined. Thus the 
euphrasia or eyebright was deemed efficacious in ophthalmic com- 
plaints, because its corolla bore a fancied resemblance to the eye ; 
hepatica, in disorders of the liver, because its leaves were some- 
what like that organ in colour; turmeric, in jaundice, because it 
was yellow; dragon's blood, in hemorrhage, because it was red; 
and mandrake, in barrenness and deficient virility, from a sup- 
posed resemblance of its bifurcated root to the thighs and body 
of a man. 

But, besides these material incumbrances, the materia medica 
was burdened, if anything so unsubstantial can be said to be a 
burden, with a vast number of purely imaginary influences ; some 
springing from mere superstition, some from erroneous science, 
some from the wildest vagaries of an excited fancy, which, not yet 
schooled in the strict philosophy of Bacon, and living in the midst 



68 HISTORY OF MATERIA MEDICA. 

of a world of mystery, viewed nothing as absurd or impossible 
which did not involve a self-evident contradiction. Not to speak 
of the healing powers ascribed to this or another shrine, to saintly 
relics, to priestly exorcisms, and to all those analogous means 
which selfish art has suggested to the misguided devotional tend- 
encies of our nature; there were the influences of the sun, moon, 
and stars; of magic, sorcery, and witchcraft; of fortunate times, 
and fortunate numbers; of charms and spells; of the royal touch, 
and of innumerable conjunctures of circumstance, to which acci- 
dental coincidence, false observation, or a bewildered fancy had 
attached the notion of positive efficiency. Many of these vagaries, 
though banished from science, still find a refuge in vulgar igno- 
rance, and the credulity of childhood. Who among you has not 
heard of that infallible cure for sties, which consists in the patient 
standing in the middle of two crossing roads, and repeating that 
erudite couplet, 

"Sty, sty, leave my eye, 

"And take the first person that passes by?" 

Who does not know that red flannel is infinitely more efficacious 
than white, and that a red string about the neck is a certain pre- 
servative against numerous distempers ? I would not undertake to 
affirm, that some of us now present have not, in our childish days, 
worn a little bag of brimstone about the person, to secure it against 
a rather vulgar infection from our school companions. We may 
wonder that all these absurdities could ever have entered into the 
creed of the cultivated and the learned ; but, when we see who and 
what many of those persons in our day are, who believe in clair- 
voyance and other extravagances of animal magnetism, and what 
numbers of distinguished persons, male and female, but especially 
the latter, swallow with a charmingly infantile faith and simplicity 
the millionth of a grain of silex, or some other equally powerful 
homoeopathic medicine, and believe themselves cured ; our wonder 



HISTORY OF MATERIA MEDIOA. 69 

at the past may well be exchanged for a feeling of deep humility, 
at the real feebleness of the much boasted human intellect. 

A new era in our science commenced with the eighteenth cen- 
tury. The inductive system of philosophy passed, it is true, very 
slowly into medicine. In relation to 'the functions of our system, 
in health and disease, so much is unknown as to afford an irresist- 
ible temptation to the speculative spirit, which loves to expatiate 
in the misty obscure, where no stumbling-blocks of fact lie in the 
way of its weakness, and no torch of truth shines upon its defects. 
It was not till within our own times that this spirit of hypothesis 
yielded to that of investigation ; and it still occupies many an intel- 
lectual strong-hold, from which it is not likely to be expelled so long 
as the sports of fancy are found less fatiguing than the labours of 
research. Yet the general current of human thought has, since 
the days of Bacon, set so strongly into the channel of strict induc- 
tion, that our science could not but feel its influence in some de- 
gree; and, though the materia medica has more or less followed 
the devious flights of medical theory, yet the claims of individual 
substances, whether of old or recent origin, to a place in its ranks, 
have been examined with much greater care, and admitted with 
much greater caution than formerly. The consequence has been 
that a vast number of inert articles have been discarded, and all 
those, which owed their introduction to the vagaries of a deranged 
imagination, have been swept away, if not from officinal catalogues, 
at least from general use. 

The unitarian theory of medicine, which recognized no other 
deviation from health than the exaltation of the vital actions 
above, and their depression below the normal standard, and con- 
sequently no other power in medicines than a stimulant or sedative 
property, had a tendency greatly to diminish the number of sub- 
stances employed, and co-operated with the new-born common 
sense of the profession in clearing away the Augean accumulations 
of preceding ages; one out of the constantly recurring examples of 



TO HISTORY OF MATERIA MEDICA. 

that order of Providence, which deduces ultimate good out of pre- 
sent evil. 

Two other agencies operated very efficiently both in reducing 
the materia medica within narrower limits, and in giving a greater 
degree of precision, order, and consistency to the remaining mate- 
rials. These were the sciences of botany and chemistry, which, 
though their seeds had been planted and begun to germinate in 
earlier times, had not pushed up into a characteristic growth until 
after the commencement of the last century. Botany proved useful 
by giving precision to the description of medicinal plants, thereby 
preventing the confounding of one with another, which had pre- 
viously been a great source of error. It also served to concentrate 
the materia medica by leading to the observation of analogous 
therapeutical properties in certain families of plants, and thus sug- 
gesting the probable inefficiency of substances, derived from any 
particular plant of an inert family. It may even in the same way 
have tended to confirm the accuracy, or correct the errors of obser- 
vation, in relation to efficacious medicines ; as the reputed virtues 
of a plant might be considered as real or suspicious, according as 
they did or did not conform with the characteristic properties of 
the family to which it belonged. 

Chemistry has been still more beneficial in its influence. Even 
in its infancy it won for medicine many rich prizes from the domain 
of nature, and has continued to yield it new and valuable acces- 
sions even down to our own times. Witness iodine and its com- 
binations, which have been added to the materia medica since the 
commencement of the present century. But its usefulness has been 
experienced even more in the selection, preparation, and various 
combination of the raw material than in its collection. Teaching 
the intimate nature of bodies, it afforded the means not unfre- 
quently of ascertaining their relative value, of choosing the best 
out of a number having similar properties, and of sifting out the 
useful from a mass of the worthless or injurious. By making known 



HISTORY OF MATERIA MEDICA. 11 

the relations and reciprocal actions of bodies, it originated or im- 
proved processes for their preparation, detected impurities and 
substitutions whether fraudulent or accidental, and enabled the 
prescriber to avoid all the hurtful consequences of incompatible 
admixture. Through its instrumentality, a precision before wholly 
unattainable has been introduced into all pharmaceutical opera- 
tions. Another most important service, which it has rendered to 
pharmacology, is the discovery of the active principles of vegetable 
medicines, and the isolation of these principles for practical use ; 
so that we have all the power of the original medicine without its 
uncertainty, and without the embarrassment of the inert or noxious 
matter contained in it. The art of extracting quinia from Peru- 
vian bark, which is a pure result of chemical research, is one of the 
greatest blessings which science has conferred on man. If France 
has destroyed her millions by the sword, she has also saved her 
millions by this great discovery. How infinitely preferable are 
these peaceful and beneficent triumphs of science to all the bloody 
trophies of ambition ! I would rather, with Pelletier and Caventou, 
have been the discoverer of quinia, than to have shared the gory 
honours of Napoleon, exalted as he was in genius, intellect, and 
energy of will almost above humanity. 

Under the influences above enumerated, materia medica has, 
within the last century and a half, assumed a definite and consistent 
form. It has risen from the state of embryotic chaos into the ma- 
tured dignity of science. The pharmacology of our times bears to 
that of the sixteenth and seventeenth centuries the relation which 
a regular disciplined army, with its due proportion of foot, horse, 
and artillery, well furnished, well officered, and well commanded, 
bears to the vastly superior numbers of an Asiatic host, with 
several non-combatants for each fighting man, without order, with- 
out obedience, a mere armed rabble, which breaks to pieces in its 
own onset, and shatters under the first blow. How much more 
effectively, then, are we prepared than our ancestors to sustain the 



72 HISTORY OF MATERIA MEDICA. 

encounter with disease ; to guard against its frequent ambushes, to 
conquer its strong-holds! Could the times of antiquity return, and 
a single tyro in modern materia medica be left, of all the present 
world, among the sages of the past, the hoary heads of Galen and 
Hippocrates would bow at his footstool, and Greece and Rome 
would hail him as a god. 

It remains for us, in order to close this very general sketch, to 
offer a brief account of the several departments of pharmacology 
as at present existing, and to name a few of the most distinguished 
modern writers. 

The first division of the science is that which considers the 
source of medicines, in other words, the minerals, plants, and ani- 
mals which yield them. This is denominated medical natural 
history, of which by far the most copious branch is that which 
treats of plants alone, or medical botany. The next division is 
the history of simple drugs, which embraces a description of 
medicinal substances as they are placed by commerce in the hands 
of the apothecary, including an account of the modes of collecting 
and transmitting them to market, and a statement of their sensible, 
physical, and chemical properties. The science next follows the 
drug into the shop or laboratory, and, under the name of phar- 
macy, teaches the mode of preparing it for use, together with its 
characters and relations with other bodies when thus prepared. 
Lastly, the effects of the medicine upon the healthy and unhealthy 
system, its applications to the cure of disease, and the modes of ad- 
ministering it, constitute the subjects of another and most import- 
ant department, that, namely, of therapeutics. Toxicology, or the 
history of poisons, may also be considered as forming a division of 
pharmacology ; for most poisonous bodies are nothing more than 
medicines in a high grade of action ; and the substances calculated 
to ooviate their morbid effects are clearly entitled to a place in the 
materia medica. These several subjects, however, are seldom en- 



HISTORY OF MATERIA MEDICA. 73 

tirelj distinct in practical treatises, which often embrace two or 
more, or even the whole of the departments, and, when ostensibly 
confined to one, frequently step over its boundaries into a neigh- 
bouring province. 

The writers of the middle ages, being few, and mere copyists of 
the ancients, do not merit a particular notice. Among those of 
the sixteenth and seventeenth centuries were several whose names 
are still held in respect, though their works are scarcely ever con- 
sulted except by the curious. Such were Tragus, Tabernsemon- 
tanus, Csesalpinus, Bauhin, Pison, and Margraf, who wrote upon 
medicinal plants; Basil Yalentine, Paracelsus, and Glauber, who 
directed their attention especially to chemical remedies ; and Shroe- 
der and Hoffman, who treated of medicines in general. Of the 
authors of the last 150 years, who have written upon pharmacology 
in one or more of its branches, the most distinguished are, in 
Sweden, Linnasus and Bergius ; in Germany, Cartheuser, Murray 
of Gottingen, Yogel, Plenk, Sprengel, Trommsdorff, Hayne, Nees 
von Esenbeck, Bucholz, Brandes, Geiger, and Richter; in France, 
Lemery, Tournefort, Chomel, Baume, Alibert, Yirey, Guibourt, 
Chevallier, Richard, Pee, Henry, Batier, Soubeiran, Orfila, Merat, 
De Lens, Trousseau, and Pecloux ; in England, Lewis, Woodville, 
Cullen, the two Duncans, Murray of Edinburgh, Paris, Thomson, 
Brande, Christison, and Pereira. Of these, Chomel, Pleck, Woocl- 
ville, Hayne, Richard, and ^ees von Esenbeck treated especially 
of medical botany; Lemery, Guibourt, Pee, and Geiger, of the 
history of drugs ; Baume, Brandes, Henry, Ratier, Soubeiran, and 
Brande, of pharmacy; Orfila and Christison, of poisons; the re- 
mainder, of the subject of materia medica in general. I do not 
speak of the writers of this country, because, in a previous intro- 
ductory lecture, I treated at large of the history of the materia me- 
dica within the United States, and, on that occasion, endeavoured 
to do justice to those who had, by their writings or otherwise, con- 



14 HISTORY OF MATERIA MEDICA. 

tributed to the advancement of our science on this side of the 
Atlantic* 

I am aware that, in the list of European authors just given, 
many have been omitted, some, perhaps, as much entitled to dis- 
tinction as those mentioned. I am aware also that a mere enume- 
ration of their names is but a very meager satisfaction, either of 
their just claims, or your proper curiosity; but time is wanting for 
a fuller consideration of the subject in this place ; and opportunity 
will frequently be offered hereafter, when upon the subject of par- 
ticular medicines, to give due credit to those who have deserved 
well of the science by their contribution of material, fact, or useful 
reflection. 

I have thus, gentlemen, introduced the materia medica to your 
notice. You will find it altogether worthy of your acquaintance, 
and may be assured that it will repay abundantly your most solicit- 
ous ^cultivation. True, it does not possess many charms for the 
careless eye. The recollections of boyhood, when the nauseous 
draught was forced by parental anxiety down your reluctant throat, 
are altogether against it. The very odour of the drug-shop natu- 
rally indisposes to a close association with the drugs themselves. 
The nature of the science, moreover, is so manifold, that a laborious 
attention is necessary even to a moderate intimacy. But when you 
come to know it well, you will rejoice that you overcame the first 
feeling of disinclination. You will find it a true friend in your 
time of need, aiding you in your daily encounters with disease, 
inspiring confidence, and offering means of relief, when there would 
be no hope without it; and, where you cannot save, enabling you 

* Though the lecture here referred to preceded, in the order of delivery, 
that which is now occupying the attention of the reader ; jet, in the rela- 
tion of subject-matter, it should obviously take a subordinate position; and 
I have accordingly placed it second in the series. 



HISTORY OF MATERIA MEDICA. ?5 

to smooth the way of the departing, and to shed comfort on the 
last hour. You. will, therefore, gentlemen, I know, honour my 
introduction ; you will give your best regards and your best 
efforts to the science ; and I shall be happy to stand by, en- 
couraging your zeal, and assisting your labours to the utmost of 
my ability. 



LECTURE II. 

DELIVERED NOVEMBER 3rd, 1840. 



History of Materia Medica in the United States. 

Allow me, gentlemen, before proceeding to the peculiar duties 
of the occasion, to greet heartily my old friends among you, and 
to those who are here for the first time to proffer my kindest re- 
gards, while I ask for theirs in return. It is always my desire, 
when entering with the class upon our mutual labours for the 
winter, that we should go hand in hand together. Not only is the 
way thus rendered more agreeable both to teacher and pupil ; but 
they are also enabled to advance more rapidly; as the intellect 
always operates with greater efficiency when aided by the affec- 
tions. That head must be empty indeed which the heart cannot 
stimulate into action. The consciousness that he possesses the 
good will of his class is to the lecturer one of the most powerful 
incentives to exertion ; and instruction seldom fails to sink deeply 
into the learner, when he feels that it proceeds as much from in- 
terest in his welfare as from a sense of duty. Let us, therefore, 
gentlemen, set out as friends upon our contemplated journey. You 
will find me disposed to do everything, during its course, which 
will contribute to leave us friends at the end of it. 

I have selected, as the subject of this introductory discourse, 
the history of the materia medica in the United States. In this 
choice, I do not wish to be considered as actuated by any narrow 
(16) 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 77 

preference of the discoveries or improvements, made in our own 
country, over those of foreign origin. Our patriotic partialities 
have been appealed to in favour of American medicine, in contra- 
distinction to that of the old continent. But this is folly, or some- 
thing worse. Medicine is a science, and science is truth brought 
to light. Now truth is one everywhere. She is of no place or 
country. Wherever she may be brought forth, from the moment 
of her birth, she belongs equally to the whole world. She brooks 
no individual or national fetters; but is the common friend and 
servant of mankind. To speak of an American truth would be 
absurd. Would it be less so to speak of American medicine, as 
something distinct from the general science ? But, though it be- 
comes us to throw aside that impolitic self-conceit of patriotism 
which undervalues whatever comes from abroad, and stigmatizes 
with the ancient Greeks and modern Chinese everything foreign as 
barbarous, we may justly and profitably endeavour to estimate the 
amount of truth which our country has contributed to the general 
mass, and thereby stimulate a generous emulation to augmented 
efforts, either to supply deficiency, or to achieve or maintain an 
honourable precedence in the race of improvement. This is all 
that I propose in calling your attention to the materia medica of 
the United States. 

In treating of this subject, I propose, first, to give a general 
view of the medicines which our country has famished to the 
world, and of the resources she contains within herself; secondly, 
to speak of the condition of this department of medical science, 
and of the individuals who have contributed to its promotion 
within our limits ; and thirdly, to offer you some inducements to 
exertion in the development of our yet hidden, or but partially dis- 
covered treasures. 

If we extend our view to the whole American continent, we have 
to boast, on this side of the Atlantic, of medicinal resources inferior 
probably to those of no other section of the globe. Not to men- 



78 HISTORY OF MATERIA MEDIC A IN THE U. STATES. 

tion numerous substances of little importance, we have, in the Peru- 
vian bark, the most valuable of all tonic medicines, scarcely indeed 
surpassed in efficiency and extent of application by any other arti- 
cle of the materia medica; in the quassia of Surinam and the 
West Indies, the strongest of the pure vegetable bitters ; in the 
rhatany of Peru, one of the most efficient astringents ; in the ipe- 
cacuanha of Brazil, the best of all vegetable emetics; in the jalap 
of Mexico, the best vegetable hydragogue cathartic ; in the balsam 
of Tolu, a good stimulant expectorant; and finally, in copaiba, and 
guaiac, and sarsaparilla, medicines of peculiar and valuable pro- 
perties, such as could not well be dispensed with in the practice of 
our art, and could not be replaced elsewhere. But none of these 
substances are found in the United States ; at least none of them 
are furnished to commerce by the soil of our country. 

It is, indeed, singular, considering the extent of our territory, the 
diversity of its climate, and the vast number of its vegetable pro- 
ductions, that so few medicines from this source have been ad- 
mitted into the European catalogues of materia medica, or even 
come into general use among our own practitioners. When I have 
mentioned lobelia, sassafras, seneka, serpentaria, spigelia, toxico- 
dendron or poison oak, and the Canada and common white turpen- 
tines, I should be at a loss to add the name of another medicine, 
procured exclusively from the territory of the United States, or 
north of it, which has been introduced to any considerable ex- 
text into European practice. It is true that there are several 
medicinal plants common to North America and the old continent ; 
such as the bitter-sweet, dandelion, hop, Iceland moss, juniper, 
pipsissewa, thorn-apple, and uva ursi. But, even with this addi- 
tion, the catalogue of our indigenous medicines recognized abroad 
is very meager ; and it is a question of some interest, how it hap- 
pens that so great a disproportion exists between the extent of our 
country and its contributions to the general materia medica. It 
is not that our native resources, in this respect, are peculiarly de- 



HTSTORY OF MATERIA MEDICA IN THE U. STATES. Y9 

ficient. On the contrary, as I shall soon have occasion to show, 
the United States are rich in indigenous medicinal products. But 
there is a coincidence in properties, real or supposed, between the 
old standard medicines and many of those of native origin, which 
has caused them to be applied to the same states of disease ; so 
that the substitution of the latter for the former could yield no 
advantage sufficient to overbalance the influence of habit in prac- 
titioners, their natural want of confidence in untried means, and 
the various facilities for prescription, afforded them by a regu- 
lar supply of the drug through established commercial routes, 
and long-settled modes of pharmaceutical management. Labour, 
moreover, is in this country too costly to compete with that which 
supplies most of the foreign drugs. We wield the various means 
of profit on too large a scale, and are too much accustomed to the 
floods of gain which pour in from vast fields of labour and enter- 
prise, to pay much regard to those dribblets that accrue from the 
collection of barks and roots. Hence, the supply of our indigenous 
medicines is not such as to enable them, upon considerations of 
economy, to displace those already in use of equal or better under- 
stood virtues ; and the consequence is that the general demand for 
them is confined, to substances of peculiar properties, such as could 
not be elsewhere procured. The influence of our national habits 
of labour upon the commercial value of drugs, is strikingly illus- 
trated in the very great increase in price of spigelia or pink-root, 
since the emigration of the Cherokee Indians, by whom chiefly it 
was in former times collected and sent to market. 

I have said that the United States are rich in medicinal pro- 
ducts. This will be rendered obvious by running the eye over a 
list of the more important indigenous medicines, classified accord- 
ing to their effects upon the system. Under the head of astrin- 
gents, we shall find the bark of different species of oak ; the roots 
of the blackberry, dewberry, Geranium maculatum, and Heuchera 
Americana or alum-root; and the leaves of the pipsissewa and uva 



80 HISTORY OF MATERIA MED1CA IN THE U. STATES. 

ursi. Among these are medicines capable of being employed for 
any object attainable by means of the class to which they belong, 
at least of the portion of it derived from the vegetable kingdom. 
In ionics our country is very rich. It is true that we have no cin- 
chona; but, in the barks of the different species of cornus or dog- 
wood, we have remedies analogous, though inferior to it in virtues. 
Of the simple bitters, sabbatia, coptis, and xanthorriza might be 
substituted for gentian, quassia, and columbo. The union of various 
important properties with the purely tonic, as those of a stimulant 
in serpentaria, of a narcotic in hops, of a sedative in wild-cherry 
bark, of a diaphoretic and emetic in boneset, renders these me- 
dicines of great value ; and those of them, not hitherto introduced 
into the universal materia medica, highly deserve to be so. I 
consider wild-cherry bark as among the most efficient remedies in 
the tuberculous diathesis, and not inferior to any other medicine 
in the treatment of consumption itself.* Our catalogue of aro- 
matics is also copious, including, among others, angelica, calamus, 
sassafras, hedeoma or pennyroyal, common marjoram, partridge- 
berry, and spice-wood or laurus benzoin. Of stimulants we have 
turpentine and its volatile oil; of narcotics, stramonium and dul- 
camara ; of antispasmodics, dracontium and cimicifuga. Our emet- 
ics, if we leave ipecacuanha out of the question, are inferior to 
those of no other country. Lobelia, though so much abused by 
empirics, is possessed of highly valuable properties; gillenia is 
supposed to resemble the famous Brazilian root in its action ; and 
sanguinaria conjoins with its emetic properties others of a peculiar 
nature, which are thought to render it especially useful in certain 
forms of disease. Among the cathartics, we have substitutes for 
several of those imported, as in cassia marilandica for senna, in 
extract of butternut for rhubarb, and in podophyllum for jalap. 

* This was written before the introduction of cod-liver oil ; and, with this 
exception, I consider the remark as still holding true. 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 81 

We are not wanting in diaphoretics or diuretics, and as an expec- 
torant our seneka holds, in my estimation, the very highest rank. 
As epispastics we have several species of Cantharis not inferior in 
virtues to the Spanish fly; and the Cantharis Nuttalli of the far 
West may some time come into extensive use, as it is said to be 
abundant, and has the advantage of equalling if it does not exceed 
the foreign insect in magnitude. Our native turpentine and its 
volatile oil, together with hemlock pitch, are good rubefacients; 
slippery-elm bark is an excellent demulcent and emollient; and 
perhaps in no part of the world are there vegetable anthelmintics 
more efficacious than spigelia and chenopodium. In this enumera- 
tion I have not attempted to exhaust the whole catalogue of native 
medicines. My object was only to show that our resources are 
ample, by calling attention to the more prominent of those sub- 
stances the virtues of which are known. Besides those mentioned, 
there are many others which have been more or less investigated ; 
and I have no doubt that some yet lie buried in the mass of our 
luxuriant vegetation, which will one day be brought to light, to 
the honour of their discoverers, and the benefit of mankind.* 

More than fifty years ago, the opinion was advanced by Shoepf 
that, relying upon their native resources, the Americans might 
dispense with the greater part, if not the whole, of the imported 
medicines. Even at the present time, however, with all the im- 
provement which half a century has conferred upon our indigenous 
materia medica, I cannot coincide wholly in this sentiment. The 
present standard remedies are for the most part those which have 
stood the test of ages. They have been gathered from all quar- 

* Since this lecture was delivered, Veratrum viride or American helle- 
bore, and Leptandra, have acquired a reputation, the former as a sedative, 
the latter as a cholagogue cathartic, which, had it then existed, would have 
insured their admission into the above list. The common poke-root, Phyto- 
lacca decandra, has considerable reputation as an alterative cathartic. 

6 



82 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

ters of the globe, have gone through every variety of trial, and 
have been sifted out from an immense mass of materials, which 
had been for thousands of years in the course of accumulation. 
Happy the country which can boast itself the source of one of the 
more important of these remedies ! It will hold a place in the 
memory of mankind so long as human infirmity shall exist, and, 
even with no other claims upon our sympathies, will rank among 
the* valued spots of the earth, when countries which derive their 
importance from mere temporary causes shall have been forgotten. 
The whole human family will ever look to the region of the Andes 
with interest, as the source of Peruvian bark, even though the 
political clouds which now overshadow her shall deepen into ten- 
fold darkness, and her moral culture become as desolate as her own 
icy summits. It is not in the order of Providence to lavish on any 
one country a wealth, equal to that scattered over the whole world 
beside. Not even the microscopic eye of patriotism could magnify 
our medicinal riches into competition with those of the entire 
globe. They are, however, very ample; and, should political acci- 
dent ever cut off our supply of drugs from abroad, though the 
want of them would certainly be severely felt, we should never- 
theless be able, in the products of our own soil, to find partial 
substitutes for almost all that we had lost. It becomes us most 
carefully to cultivate our resources, both that we may be fully pre- 
pared against whatever adverse events may occur, and in the hope, 
moreover, that we may thereby add something new and valuable 
to the means alre'ady existing for the alleviation of human evil. 

It is an interesting subject of inquiry, in what manner attention 
was first attracted to the medicinal plants of this country. When 
our ancestors had established themselves in their new home, and 
began to investigate with the eye of curiosity or interest the 
various novelties around them, it was natural that they should at 
once be struck with resemblances to familiar objects, and should 
expect a similarity in properties where they found a similarity in 



HISTORY OF MATERIA MEDICA IN THE II. STATES. 83 

appearance. The care of their health no doubt early directed 
their inquiries towards medicinal products; and plants, resembling 
the simples with which they had been familiar, received correspond- 
ing names and similar applications. Thus we have our centaury, 
our dittany, our hellebore, our pennyroyal, our senna, our worm- 
seed, and numerous others so closely allied to the European plants 
by botanical affinities as to be entitled to ,the same generic desig- 
nation, such as the elder, the elm, the oak, the pine, and the willow. 
In this way a domestic materia medica was immediately com- 
menced, which gradually increased as substances before unknown 
were accidentally, or from the possession of certain striking sen- 
sible properties, submitted to trial, and found or imagined to ope- 
rate usefully as medicines. Several substances were also derived 
from the aborigines, of which the most important are seneka, ser- 
pentina, and spigelia. 

It was at one time a general belief that the Indians were in 
possession of many valuable remedies, and had even specifics for 
various obstinate complaints which had baffled European skill. 
These they were supposed to keep secret from some mysterious 
cause, which acted powerfully on the popular faith by exciting the 
imagination. A class of empirics took advantage of this supersti- 
tion, and, under the name of Indian Doctors, spread themselves 
over the country, imposing their nostrums upon the public credu- 
lity as secrets obtained from the aborigines, and decrying, with 
all the zeal of the Thompsonians who have succeeded them, the 
poisonous minerals employed by the regular practitioners. But 
faith in the superior medical knowledge of our savage tribes is dis- 
appearing with the tribes themselves. The simple truth seems to 
be, that many of the indigenous medical plants were known and 
employed, though very unskilfully, by the Indians, who communi- 
cated all they knew to the Europeans upon their settlement in the 
country. Whatever mystery may have, in some instances, been 
thrown over the subject, was a contrivance of imposture to conceal 



84 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

its real ignorance, or to magnify, through the effect of partial ob- 
scurity, its little grain of knowledge into something worthy of 
notice. 

The wants of the country during the war of independence, when 
the supply of drugs as well as other necessaries from abroad was 
very much impeded, stimulated attention to our indigenous re- 
sources, and led, if not to the discovery, at least to a fuller investi- 
gation and more extensive use of various native medicines. 

Another circumstance which contributed very considerably to 
the cultivation of our native materia medica was the regulation, 
formerly existing in this school, which required the publication of 
the inaugural dissertations of the graduates. A laudable regard 
to their reputation stimulated the exertions of the candidates, 
many of whom were induced to extend their researches into the 
yet but very partially explored region of our native medicines, and 
were rewarded by discoveries either of new substances, or of new 
and valuable properties in those already known. 

It is due to those who have aided in bringing a fresh soil of 
knowledge into culture, that their names and services should 
from time to time be revived in the memory of their successors, 
who are enjoying the fruits of their labours. It is, besides, a 
healthy excitant of our own exertions, thus to have placed before 
us the example of useful effort, and its just reward of commenda- 
tion. An account, therefore, of the earlier writers upon our indi- 
genous materia medica may be justly expected from a teacher of 
that science, addressing those who are to be at once the deposi- 
taries of the reputation of their predecessors, and claimants of a 
like office from posterity towards themselves. I wish to make the 
proposed sketch as full as the occasion will permit; but it will be 
necessarily inadequate, and should be filled up by your own further 
research. 

The earliest notices which I have been able to discover of North 
American medicinal plants are those contained in the Flora Yir- 



HISTORY OF MATERIA MEDICA IN THE TL STATES. 85 

ginica of Dr. John Clayton, published at Leyden by Gronovius in 
1739. Dr. Clayton was a native of England, but emigrated early 
in life to Yirginia, where he became eminent as a naturalist and 
physician, and died in 1773, at the very advanced age of 88 years. 
Dr. Thacher states that he published, in the Philosophical Trans- 
actions, an ample account of the medicinal plants which he had 
discovered. It is his name, I presume, that has been enshrined in 
the botanical designation of that beautiful little spring flower, the 
Glaytonia Virginica. 

In the years 1743 and 1744, similar medico-botanical notices of 
plants, growing in the province of New York, were published in 
the Upsal Transactions by Dr. Cadwallader Colden, a gentleman 
of considerable scientific and political distinction, who came from 
Great Britain to this country about the year 1710, and established 
himself in that province. 

But, perhaps, the most ample of these earlier contributions was 
that by John Bartram, a native, I believe, of Pennsylvania, who 
was distinguished as an indefatigable cultivator of botany, and is 
very favourably remembered in this city as the founder of the 
botanical garden upon the Schuylkill, which has always gone by 
his name, and is still in the hands of one of his descendants.* 
His essay, containing a description of several medicinal plants of 
North America, was printed in the year 1756, in the Amcenitates 
Academics of Linnaeus, as a portion of a paper denominated Spe- 
cified Canadensium, prepared by John Yon Colin, and intended 
to embrace what was at that time known in relation to the materia 
medica of this country. 

In subsequent years, various additions were incidentally made 
to the store of knowledge by writers upon other subjects, as by 



* This splendid botanical garden has subsequently passed into other 
hands, and is now greatly deteriorated, if, indeed, it retains at all its 
original character. 



86 HISTORY OF MATERIA MED1CA IN THE U. STATES. 

Catesby in his Natural History of Carolina, and by Kalm, a Swe- 
dish gentleman, who travelled in North America about the middle 
of the last century, and published an Itinerary on his return to 
Europe. 

The first work devoted expressly to the materia medica of North 
America was that of Dr. Shoepf, a German physician, who came 
with the Hessian troops to this country during the revolutionary 
war, and remained for some years after its termination, travelling 
through the different States, and giving an especial attention to 
the study of plants. After returning to Europe, he published, at 
Erlangen, in Germany, a treatise in the Latin language, under the 
title of Materia Medica Americana, describing with scientific 
brevity a great number of our indigenous and naturalized plants, 
with the shortest possible account of their sensible properties, 
effects on the system, and medical uses. His work, however, can 
be of little use to the practitioner; for, though he has introduced 
everything into it with an indiscriminating eagerness, his practical 
remarks are exceedingly vague, meager, and unsatisfactory ; and 
even the dose and proper mode of administration are, for the most 
part, withheld. 

A much more valuable practical essay was that of Doctor 
Benjamin Smith Barton, formerly professor of materia medica, 
and afterwards of the practice of medicine in this University, 
whose various knowledge, zeal in the prosecution of natural his- 
tory, and talents as a medical teacher are still fresh in the recol- 
lection of the profession. No one man in the United States, I 
presume, has contributed so much to the improvement of our 
native materia medica. Not only did he diffuse by his writings 
and lectures the knowledge which he had accumulated by diligent 
research, but he breathed a spirit of investigation into the young 
men who heard him, that produced a rich result of discovery. The 
work referred to lays no claim to the consideration of a regular 
treatise, being modestly entitled "Collections for an Essay towards 






HISTORY OF MATERIA MEDIC A IN THE U. STATES. 87 

the Materia Medica of the United States," and consisting of mate- 
rials partly gathered from preVious writers, partly accruing from 
his own inquiries and observations, and thrown together without 
any great attempt at elaboration. His aim appears to have been 
to collect into a single repository, of convenient access, facts which 
might otherwise have been lost, or, from their scattered condition, 
have remained inaccessible to ordinary research. His book has 
been a storehouse of materials for subsequent authors, and will 
probably continue to be at the fountain-head of inquiry; as it con- 
tains all that an investigation pushed into the times beyond it 
would be likely to discover. It consists of two parts, the first of 
which was published in 1798, and afterwards with some additions 
in 1801; while the second part did not make its appearance till 
1804. 

It would be impossible for me, consistently with my present 
design, to mention individually the numerous inaugural essays and 
monographs published in the journals, in relation to particular in- 
digenous medicines. Many of these have considerable merit, and 
some have been the means of introducing to general notice valu- 
able remedies, which have since retained a place in the public 
esteem. It was soon after the appearance of Dr. Barton's Collec- 
tions, that the attention of students of medicine appears to have 
been most strongly directed into this channel; for in the year 
1802, not less than six theses on the subject of our medicinal 
plants were published by alumni of this school, though the whole 
number of graduates of that year did not exceed twenty. 

I do not know that it is strictly in keeping with the plan of this 
lecture to call attention particularly to the botanical works, which 
appeared about this time and subsequently, and which, though 
they did not make the medicinal virtues of plants a special ob- 
ject, nevertheless contain scattered notices in relation to them, of 
some value to the physician and medical writer. It may, perhaps, 
be sufficient to mention the North American Flora of the elder 



88 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

Michaux, which was printed at Paris in 1803, and that of Frede- 
ric Pursh, who, after having been diligently engaged for more 
than twelve years in exploring the botany of this country, either 
by personal examination of the plants in their localities, or by 
means of the herbariums of others, published at London, in 1814, 
his very valuable work. 

There is another author whom it would not be just to pass over, 
without some allusion to his merits in connection with our subject. 
I refer to the younger Michaux, whose treatise on the forest-trees 
of North America, written in French, and published at Paris in 
1812, was soon afterwards translated by Mr. Hillhouse into Eng- 
lish, and printed at the same place. This is a splendid work, con- 
taining a great number of beautiful illustrative engravings, and 
embodying a vast deal of information in relation to our forest- 
trees, which, though it bears more especially upon commercial and 
agricultural interests, is yet, in many instances, of considerable 
value in a medical point of view. 

We have now come to the period of contemporary writers, in 
relation to whom prudence would recommend silence; as praise, 
though deserved, might to over-delicate ears sound like adulation, 
and censure might be ascribed to envy or the ill-will of opposite 
interests. Yet if we yield to this squeamish delicacy on the one 
hand, and to the fear of derogatory imputations on the other, we 
deprive merit of its best reward; the knowledge, namely, that it 
is justly appreciated; while impertinent. ignorance is allowed to 
strut about with impunity, and impose its fooleries or knavery 
upon modest simplicity as truth. I scarcely know why I should 
preface by these generalities the introduction to your notice of 
two works, which, from an American pen, deserve nothing but 
praise, and the character of which is so well established, that no 
commendation which I might bestow upon them would be ascribed 
to other motives than a sense of justice and patriotic pride. I 
confess, gentlemen, that I do feel some pride in naming to you the 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 89 

Medical Botany of Dr. Wm. P. C. Barton of Philadelphia, and 
the American Medical Botany of Dr. Jacob Bigelow of Boston ; 
not that these productions offer a claim to the highest rank as 
works of science or art, but that, considering the materials at com- 
mand, the state of the arts among us, and the meager patronage 
they were likely to receive, the enterprise, industry, zeal, and, I 
may say, success with which they were executed, and the great ad- 
vance which they exhibit beyond whatever previously existed here, 
are calculated to do honour to all of us as fellow-countrymen of 
their authors. The design of their execution appears to have 
been nearly simultaneously conceived, and they were both pub- 
lished in the year 1817. They consist of descriptions, somewhat 
ample, of our medicinal plants in all their interesting relations, 
with coloured engravings of these plants, and all sorts of refer- 
ences. It might be invidious to discriminate between them ; but 
if I were to venture an opinion of their relative merits, I should 
give the palm decidedly to the Philadelphia work upon the score 
of art and elegance of execution, while that of the Boston profes- 
sor might well dispute the precedence on the score of science and 
research. They have conjointly placed our native materia medica 
on a much higher footing than it stood upon before; and nothing 
has been subsequently published which could have the least ten- 
dency to throw them into shade.* 

To bring our hasty review down to the present time, we have 
only to allude to the facts, that, in the various treatises upon 
the general subjects of materia meclica and pharmacy which have 
been published in this country, our own medicines have received 
their share of attention; and that articles have occasionally ap- 
peared in the medical journals, either containing new facts, or 
presenting what was before known in a new light. 



* The date at which this lecture was delivered must be borne in mind by 
the reader. 



90 BISTORT OF MATERIA MEDICA IN THE U. STATES. 

There is, however, one circumstance connected with our present 
subject, which it would be improper to pass over wholly without 
notice; I allude to the chemical analysis of many indigenous me- 
dicines, which has resulted in a much more accurate knowledge of 
their composition, and a juster view of their pharmaceutical rela- 
tions than previously existed. The particular results have been 
consigned to the journals, and cannot of course be mentioned 
here ; but such of them as are of practical value to the physician 
will be noticed under the heads of the several medicines in my lec- 
tures. We are indebted for them chiefly to graduates of the Phi- 
ladelphia College of Pharmacy, which appears to have afforded to 
its students, in their particular pursuit, a stimulus similar to that 
which our own school, at a period of its history already referred 
to, imparted to the candidates for its honours. 

In no part of the United States, perhaps, has our indigenous 
materia medica been practically cultivated to the same extent as 
in New England, and particularly in Connecticut. Several me- 
dicines of native origin are, I am told, habitually employed by the 
regular practitioners, which are little if at all used elsewhere ; and 
Professors Ives and Tully, who have successively lectured on ma- 
teria medica in the Medical Department of Yale College, are said 
to have offered to the student a minuteness and variety of informa- 
tion upon the physiological effects and therapeutical uses of those 
medicines, which would be in vain sought for in books. It is to be 
hoped that the present professor may some time consent to share 
with his medical brethren in general his peculiar knowledge ; for it 
must be confessed that there is nothing in which we are more de- 
ficient, than in the accuracy and precision of our acquaintance with 
the virtues of most of our indigenous medicines.* 

* It is scarcely necessary to inform the reader that Dr. Wm. Tully, alluded 
to in the text, recently died, while engaged in an elaborate work on materia 
medica, of which two volumes had issued from the press at the time of his 
decease. 



HISTORY OF MATERIA MEDIC A IN THE IT. STATES. 91 

It is worthy of mention, in connection with this subject, that par- 
ticular attention has been paid to the collection and preparation of 
indigenous plants by the Shakers, who furnish, indeed, to the shops 
most of their supplies, and generally in the best condition. An ex- 
tensive business of this kind is carried on by the Shakers of Leba- 
non, in New York ; and, during a recent journey in Ohio, I found 
that at their settlement in that State they were cultivating the same 
source of profit. 

Our view has hitherto been confined to the state of materia 
medica, in relation to the objects of that science furnished exclu- 
sively by this country; we are now to consider the history and 
condition of the science in its general relations among us. A few 
words will embrace all that need be said on this subject; for the 
history of materia medica in the United States has been, till 
within a few years, identical with that of the same branch of 
knowledge in Europe. While we were colonies of England, we 
were willingly indebted to the mother country for intellectual sup- 
plies, as well as for manufactures, and, considering our credit as 
involved in hers, did not seek an independent national reputation. 
Our medical doctrines and modes of practice, the choice of re- 
medies and their modes of preparation, even the medicines them- 
selves and all their pharmaceutical modifications, were received 
from Great Britain with a filial respect, which did not allow us to 
suspect the possibility of anything better, or more applicable to our 
condition. Her authorities were our authorities, her books were 
our books, and in great measure her physicians were our phy- 
sicians ; for the great West was then the Atlantic border, and the 
young medical men from the mother country found a welcome as 
cordial as that now extended, on the banks of the Mississippi, to 
the alumni of our own schools. Nor did our professional cease 
with our political dependence. For many years after we had 
thrown off the yoke of the mother country, we continued to look 
to her authors almost exclusively as our guides in medicine. So 



92 HISTORY OS MATERIA MEDICA IN THE U. STATES. 

far as concerns the materia medica, the first effort to supply our- 
selves was in the publication, in 180G, of the American Dispensa- 
tory by Dr. John Redman Coxe. This work was little more than 
a reprint of the Edinburgh Dispensatory, with an alteration in the 
arrangement of the articles, and the introduction of some notices 
in relation to our indigenous medicines. Such as it was, however, 
it acquired great celebrity, passed through numerous editions, and, 
for many years, was the almost exclusive pharmaceutical guide-book 
of a great portion of the Union. In 1810, appeared the American 
New Dispensatory by Dr. James Thacher, of Massachusetts, which, 
with greater claims to originality, was scarcely less meritorious in 
other respects than its predecessor, and had the advantage of pre- 
senting more elaborate and better digested accounts of our native 
medicines than had yet appeared in any one work. This soon 
divided with Dr. Coxe's book the patronage of the country, circu- 
lating more especially in the Eastern States, though it also pene- 
trated into a few shops and libraries in the more Southern sections. 
In the year 1817, a new era in the history of our science in 
America commenced with the publication of Dr. Chapman's work 
on Therapeutics and Materia Medica. Hitherto we had done 
little more than add to the products of the European press our 
peculiar knowledge in relation to indigenous medicines. Dr. Chap- 
man took a bolder flight; and, by the publication of a systematic 
and original treatise, containing elaborate doctrine, interesting 
practical views, and highly important therapeutical facts of a 
general character, placed us at once upon a footing with English 
authorship in this department of medicine. If his work be con- 
sidered rather in reference to the physiological effects, or practical 
application of medicines, than to their history as objects of physi- 
cal science or pharmaceutical management, though, as they who 
have attended my lectures well know, I cannot coincide in all the 
opinions which it advocates, I can with sincerity say that I know 
of nothing superior or equal to it, among the treatises on materia 



HISTORY OF MATERIA MEDIC A IN THE U. STATES. 93 

medica in the English language, existing at the time when it was 
written. The work of Dr. Chapman was followed, in 1822, by the 
Materia Medica of Dr. Bigelow, and, in 1825, by the Materia Medica 
and Therapeutics of Dr. Eberle. The former was intended as a 
sequel to the Pharmacopoeia of the United States, of which it may 
be considered as an explanatory commentary, without claiming to 
rank as a finished treatise upon the science. The latter is an 
elaborate work, prepared with great industry and research, and 
containing much very valuable information. I should not be doing 
justice to the student without recommending to him, especially in 
the intervals of his winter labours, the diligent perusal of Dr. 
Chapman's and Dr. Eberle's treatises. 

Of the work which came next in the order of time it does not 
become me to speak, except in the most general terms. The 
United States Dispensatory, which has been adopted as the text- 
book of the ensuing course of lectures, made its first appearance 
in 1833. I may, perhaps, be permitted to say of that portion of 
the work executed by my friend, Dr. Bache, which concerns for the 
most part the chemical articles, that it is marked by all the scru- 
pulous accuracy, precision, and faithfulness, which so favourably 
characterize the author in all his relations. 

To complete the list of American works upon materia medica, 
it remains only to mention the "New Remedies" of my friend and 
co-labourer in this field of medicine, Dr. Dunglison, which was 
published in 1839. This is a valuable treatise, containing much 
information in relation to new or little employed remedies, and 
might advantageously lie on the table of every practitioner, with a 
view to occasional reference.* 



* Since the year 1840, many other works on materia medica and phar- 
macy have been given to the world by American writers. The Medical 
Formulary of Dr. Benjamin Ellis, published in 1826, and the work on Baths 
and Mineral Waters, by Dr. John Bell, first published in 1831, should have 



94 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

Haying seen what 1ms been written upon the subject of which 
we are treating, we are naturally led to the inquiry, what has been 
done Or discovered, in this country, towards the advancement or 
improvement of the science of materia medica, independently of 
tlic additions it has received from our indigenous products. The 
amount of our contributions in this way is not large. Most me- 



been noticed in the text. The following is a list, with the dates of publica- 
tion, so far as the author has ascertained, of those which have appeared 
subsequently to 1840: Dictionary of Materia Medica, on the basis of Brande, 
by John Bell, M.D., 1841 ; General Therapeutics and Materia Medica, by Robley 
Dunglison, M.D., 1843; Elements of Materia Medica and Therapeutics, by John 
P. Harrison, M.D., 1845; Adulteration of various Substances used in Medicine and 
the Arts, by Lewis C. Beck, M.D., 1846; Illustrations of Medical Botany, by Jos. 
Carson, M.D., a splendid work in two large quarto volumes, 1847; Medical 
Botany, by R. Eglesfeld Griffith, M.D., 1847 ; Materia Medica and Therapeutics, 
by Martyn Paine, M.D., 1848; Catalogue of the Medical Plants of New York, 
by Charles A. Lee, M.D., 1848; Essay on Infant Therapeutics, by John B. 
Beck, M.D., 1849; Chemical and Pharmaceutical Manipulations, by Messrs. 
C. Morfit and A. Muckle, 1849; Materia Medica and Therapeutics, by Thos. D. 
Mitchell, M.D., 1850; A Universal Formulary, by R. Eglesfeld Griffith, M.D., 
1850; Lectures on Materia Medica and Therapeutics, a posthumous work, by 
John B. Beck, M.D., edited by C. R. Gilman, M.D., 1851; Synopsis of the 
Course of Lectures on Materia Medica and Pharmacy, in the University of Penn- 
sylvania, by Joseph Carson, M.D., 1851; Outlines of a Course of Lectures on 
Materia Medica, in the Medical College of South Carolina,, by Henry R. Frost, 
M.D., 1851; Review of Materia Medica, for the Use of Students, by John B. Biddle, 
M.D., 1852; Mineral and Thermal Springs of the United States and Canada, by 
John Bell, M.D., 1855; Introduction to Practical Pharmacy, by Mr. Edward 
Parrish, 1856; Treatise on Therapeutics and Pharmacology, by the author, 
1856; and Rational Therapeutics, by Worthington Hooker, M.D., 1857. The 
unfinished work of the late Dr. Wm. Tully has been referred to in a former 
note; and a Treatise on Materia Medica and Therapeutics, by Alfred Stille*, 
M.D., is announced as in the press. Besides the publications above men- 
tioned, valuable additions have been made by their American editors to 
various foreign works on materia medica and pharmacy, reprinted in this 



HISTORY OF MATERIA MEDICA IN THE U. STATES. 95 

dicines have been so long subjected to all sorts of trial, in every 
variety of disease, that to fall upon a really new physiological pro- 
perty, or therapeutical application, is a rare occurrence ; and even 
where an individual may imagine that he has made some interest- 
ing or important discovery, the chances are great that it is a long 
known and recorded fact, of which he was ignorant from deficient 



country. Without attempting to enumerate all these, I would call attention 
to the Additions to 3Iohr and Redwood's Treatise on Pharmacy, by Prof. Wm. 
Procter, Jr., and those of Prof. Jos. Carson, M.D., to the excellent work of 
Dr. Pereira on Materia Medica. 

It would he unpardonable, in a catalogue of American contributions to 
materia medica and pharmacy, to pass without notice the American Jour- 
nal of Pharmacy. Commenced, with the title of Journal of the Philadelphia 
College of Pharmacy, in the year 1825, under the auspices of the College, 
it was suspended, after the issue of a few numbers, until the year 1829, 
when it was resumed, under the same auspices; and from that date it has 
continued uninterruptedly to the present time, having, in the year 1885, 
taken the more appropriate title of the American Journal of Pharmacy. 
The editors, who have always been aided by a publishing committee of 
the College, have been, successively, Dr. Benjamin Ellis from 1829 to his 
death in 1831, Dr. R. E. Griffith from 1831 to 1837, Dr. Jos. Carson from 
1837 to 1850, and Prof. Wm. Procter, the present editor, who followed after 
the resignation of Prof. Carson. This journal has contributed largely, at 
all times, to the progress of pharmacy in the United States, and is at present 
by far the best pharmaceutical periodical, with which the author is ac- 
quainted, in the English language. Another pharmaceutical journal, en- 
titled New York Journal of Pharmacy, was published in the city of New York, 
in the year 1852, but was suspended after a short continuance; and a third, 
now in existence, is published in Baltimore, under the name of Journal and 
Transactions of the Maryland College of Pharmacy, and bids fair to maintain 
a highly respectable position among the journals of the country. The Ame- 
rican Pharmaceutical Association has also published annually, for the last 
seven years, a volume of its Proceedings ; and the last of these volumes, 
giving the proceedings for the year 1858, contains much matter of interest 
to the medical as well as the pharmaceutical profession. 



96 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

moans of information. In the short annals, therefore, of our inde- 
pendent medical history, we are to look for very few improvements 
of the kind alluded to. Still, by running our eye over the medical 
journals, we shall find that our soil has not been entirely barren. 
From among the great mass of suggestion and reported expe- 
rience, a few facts might be picked out here and there which have 
the stamp of novelty. You will observe that I am now speaking of 
the general materia medica, exclusive of that which is the peculiar 
product of our native vegetation, and in which our contributions 
have been .ample. To mention each individual case, in which an 
old medicine may have received a new application at our hands, 
would be out of place on this occasion. Such notices belong to 
the special history of medicines, and will be introduced into my 
lectures under appropriate heads. There have, however, been two 
discoveries of American physicians which merit particular notice, 
as they have been the means of introducing, out of the mass of 
materials everywhere accessible, new and effective remedies into 
general use. One of these discoveries, made by Dr. John Redman 
Coxe, was of the existence of virtues, analogous to those of opium, 
in the inspissated milky juice of the common lettuce, which has 
consequently found a place in the officinal catalogues, both here 
and in Europe, under the name of lactucarium ; the other, due 
to Dr. Stearns, of the State of New York, was of the peculiar and 
highly important properties in ergot, which have led to its uni- 
versal adoption as an article of the materia medica,* 

There yet remains another point of view, from which to consider 
the materia medica of the United States. In every civilized coun- 

* In this connection, it is proper to refer to ethereal inhalation, as an 
anaesthetic in surgery, first brought into notice by Dr. Morton, of Boston, 
and to the employment of collodion for its adhesive qualities, which is due 
to Dr. Maynard, also of Boston; both of "which are recent discoveries, of 
American origin, and the first, perhaps the most important which has been 
made, in this department of medicine, since the discovery of quinia. 



HISTORY OF MATERIA MEDIC A IN THE U. STATES. 91 

try of Europe, it has been considered indispensable, in order to a 
due regulation of the nomenclature and preparation of medicines, 
to establish a system of rules, which should have the sanction of 
law. Without the uniformity resulting from such pharmaceutical 
codes, no physician could depend on obtaining from the apothecary 
the same medicine or preparation, under the same name, and infi- 
nite confusion, with its consequent mischief, would result. These 
codes are put forth, under the title of pharmacopoeias, by colleges 
or other authorized bodies, and, having the sanction of the govern- 
ment, constitute a part of the public law. Thus, the pharmacy of 
England is regulated by the London College of Physicians through 
their pharmacopoeia, that of Scotland in like manner by the Edin- 
burgh College, and that of Ireland by the Dublin College.* In this 
country we were long without any such generally recognized code ; 
and the preparations were made according to the directions of one 
or another of the British Colleges, at the discretion of the apothe- 
cary, or even according to some favourite recipe of his own ; so 
that compounded medicines of the same title were often entirely 
different in different sections of the country, and even in different 
shops of the same town. The first effort to remedy this evil, of 
which I have any knowledge, was made in 1808 by the Medical 
Society of Massachusetts, by which measures were taken for the 
preparation of a pharmacopoeia, which was published, and was 
afterwards adopted by the Medical Society of New Hampshire. 

* In consequence of a recent act of the British parliament, regulating, in 
some degree, the medical profession in Great Britain and Ireland, the three 
pharmacopoeias hitherto recognized are to be consolidated into one; and a 
committee, under the auspices of the general Medical Council, which may 
be considered as the representative of the whole profession in the British 
Islands, is at this moment engaged in preparing a pharmacopoeia, which is 
hereafter to be the sole standard for the empire. If no other good than 
this shall result from the recent movements of the medical profession in 
England, all the time, trouble, and expense which they have cost, will be 
far overpaid. 

1 



98 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

But no general movement took place till about the beginning of 
the year 1820, when a convention of physicians from various parts 
of the country met at Washington, and framed a pharmacopoeia, 
which was intended to express the sentiments of the profession 
throughout the Union, and thus to acquire an authority which we 
have not the means of conferring on such a work by law. It was 
denominated the Pharmacopoeia of the United States, and was 
received, to a considerable extent, as the pharmaceutical standard 
of the country ; but its many defects and errors, such as are inci- 
dent to a new undertaking, and especially to one in which nume- 
rous irresponsible hands are engaged, prevented its universal ac- 
ceptance. Provision, however, had been made for the supply of 
these deficiencies by a revision at the end of ten years. Accord- 
ingly, in January, 1830, a second convention met at Washington, 
by whose authority a revised and very much amended edition was 
published. This has been subsequently admitted by the country 
in general as an authoritative pharmaceutical code, though, in the 
absence of any legal sanction, it has not been altogether sufficient 
to restrain propensities to independent action on the part of indi- 
viduals. In order to render the work still more worthy of the 
place which it claims to occupy, as well as to bring it up to the 
present level of our knowledge, a third convention, which met at 
the commencement of the present year in Washington, provided 
for another revision, to the aid of which the colleges of pharmacy 
were invited, so that the practical and peculiar skill of the apothe- 
cary might be brought into co-operation with the knowledge of the 
physician. This aid has been secured ; and the pharmacopoeia has 
been submitted to a thorough examination, which it is hoped will 
end in such an improvement as to render it generally if not univer- 
sally acceptable.* 

* The revised pharmacopoeia was published in 1842; and another revi- 
sion, under the auspices of a convention which met at Washington in 1850, 
issued from the press in 1851. A fifth convention is to meet at the same 



HISTORY OF MATERIA MEDIC A IN THE XL STATES. 99 

I have alluded to the pharmaceutical colleges. It is not inap- 
propriate to the occasion to state, that these institutions — of which 
one has been in efficient operation in Philadelphia since the year 

1822, and another, subsequently founded, is now in operation in 
New York — have contributed very greatly to improve the art of 
preparing medicines in this country, and, by elevating the profes- 
sion of pharmacy, have rendered it a much more efficient auxiliary 
to ours. The late convention at Washington has, I think, merited 
well of the country in inviting the co-operation of these colleges 
in an important national work, in which both professions are 
equally interested, and which can scarcely be satisfactorily com- 
pleted unless by their joint labours.* 

. And now, gentlemen, having conveyed you through a brief his- 
tory of the materia medica in this country, will you allow me to 
urge upon you the application of your own efforts to the improve- 
ment of this branch of medicine, and especially of that portion of 
it which concerns our indigenous products ? I know no fairer field 
for ycu than this, in which to gain a name for yourselves, or accom- 
plish something useful to your profession. Success would be doubly 
grateful to a patriotic spirit ; for, while your country would share 
in the honour which might accrue to one of her sons, she would 
enjoy the advantage also of a cultivation of her own peculiar re- 
sources. Can I not paint to your fancy a prospect which will 
rouse all your energies to realize it ? Suppose that, by a careful 

place in May next, which -will submit the work to another decennial revi- 
sion. By the careful scrutiny to which the pharmacopoeia is exposed at this 
regular interval of ten years, the opportunity is afforded of correcting its 
errors, and supplying its deficiencies ; so that it is rendered a just expres- 
sion of the knowledge of the times, and has come to be almost universally 
acknowledged as a legitimate standard for the country. 

* Besides the Philadelphia and New York Colleges, referred to in the 
text, another has been since established, and is in full operation in Balti- 
more; and, as I have been informed, a third has been organized in Chicago. 



100 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

and laborious investigation, by a long course of varied experiment 
and accurate observation, you have arrived at the discovery of 
some valuable medicine hitherto concealed in the wilds of our 
country, or of some yet unknown peculiarities and powers of a 
medicine already recognized. Your name is at once honourably 
known in connection with your discovery; through life you will 
have the consciousness that you at least are not among those who 
pass undistinguished along their destined course, and leave no 
trace behind them ; your children and your children's children will 
inherit the imperishable treasure of your reputation. In the pages 
upon which succeeding generations of students will dwell, your 
name will be connected with the record of the good that you have 
accomplished ; in the lectures to which future aspirants for medi- 
cal honours will listen, your claims will not be forgotten when your 
discovery is alluded to ; perhaps from this very spot, some future 
professor, giving, as I have done to-day, a history of the materia 
meclica of our country, may cite your example as an honour to the 
institution, and a powerful incentive to his pupils. It is some- 
thing also to possess the consciousness that you have added to the 
credit of your profession, and have been a benefactor to your 
country and to mankind. These, it is true, are motives of action 
common to every honourable field of exertion ; the peculiar induce- 
ments in that now offered to you are the deficiency of present cul- 
ture, and the greater probability of a rich return for all the labour 
expended. Our native materia medica may be said to have lain 
fallow for several years. Pathology has by its fruitful yield drawn 
almost all floating labour to itself; and fashion has invested it 
with additional attractions. Our comparatively neglected science 
has, in the mean time, through the progress of general discovery, 
been accumulating renewed fertility, and will yield abundantly to 
properly directed culture. May I not hope that some of you, 
under the inducements which I have presented, or others which 
your own minds may suggest, will engage heartily in this work of 



HISTORY OP MATERIA MEDICA IN THE U. STATES. 101 

investigation, in the pursuit of the high prize of honour for your- 
selves, your school, your profession, and your country? 

But you must remember that such a prize is not easily won. 
We cannot guess ourselves, nor dream ourselves into honourable 
distinction. The pursuit of a creditable name is no lottery, in 
which the highest prize may be drawn by careless indolence, or 
self-satisfied ignorance. You must work, if you would gain the 
wages of labour. 

Having thus called you to exertion, I may very properly be re- 
quired by you to point out the best plan of beginning and con- 
ducting your investigations. Your first object will be to select 
some particular subject of inquiry. You may choose some indi- 
genous plant, whose medicinal properties have already attracted 
the notice of the profession, but have not been thoroughly studied ; 
or you may search amidst the rubbish of popular and domestic 
practice, and find something perhaps of value which has hitherto 
lain concealed; or, finally, you may examine the plants of our 
woods and meadows, and, guided by the odour, taste, or other ob- 
vious property indicating some power of affecting the human sys- 
tem, may perchance be led to the discovery of a useful and hitherto 
unknown medicine. I would recommend the first course ; as the 
catalogue of officinal or semi-officinal plants is already numerous, 
and it is desirable to sift this thoroughly before attempting to aug- 
ment it. 

In the very beginning, you must take care to avoid the too 
common error of explorers, of determining at all events to find 
something new — a determination which is apt to deceive the fancy 
into the belief that it has discovered what it has in fact only in- 
vented. Let your search be after truth, and nothing but truth. 
It may be as important to deprive a counterfeit medicine of its 
false credit, as to add a new one, though genuine, to the mass of 
circulation. You will perform an important service, if you can 
prove satisfactorily that one of the received medicines is quite 
valueless. 



102 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

Having selected the subject of experiment, you are first to ascer- 
tain its effects upon the human system in health. Try it upon 
yourselves, upon your friends, upon persons of different sex, age, 
and temperament, beginning with doses which you know to be 
safe, and gradually increasing till its activity or inertness is 
evinced. Ascertain its influence upon the brain and nervous sys- 
tem, upon the stomach and bowels, upon the heart as indicated by 
the pulse, upon the temperature of the body, upon the secretions, 
and in fine upon all the healthy functions. Note all these effects 
carefully as you observe them ; but at the same time be very cau- 
tious not to confound those changes in the system which may re- 
sult from mental influence, or from the operation of ordinary or 
accidental causes, with those which are the genuine product of the 
medicine. Do not be satisfied with a single trial in each case, but 
repeat it, with varying circumstances, till there can no longer be a 
doubt of the actual effect produced. 

When you have sufficiently convinced yourselves of the efficiency 
of the medicine, and ascertained its peculiar physiological action, 
you are next to apply it to the treatment of disease; and here the 
same caution is requisite not to allow yourselves to be misguided 
by the influence of various disturbing agencies, nor to make hasty 
conclusions from one or a few trials. There is nothing in relation 
to which we are more apt to draw false inferences than the action 
of medicine in disease. Most complaints have a tendency to spon- 
taneous cure, and will in general go on sooner or later to recovery, 
without the use, and often notwithstanding the use of medicine. 
In such cases, the last drug administered is apt to have the credit 
of the cure, though all its operation may have been to protract 
this result. There are numerous causes which operate on the 
system in disease, giving rise to changes not anticipated, which, 
without due caution, may be ascribed to the remedies employed. 
Against all these sources of error you must be on your guard, and 
above all against your own hopes, which will act powerfully in 
causing you to see things as you wish them. 






HISTORY OF MATERIA MEDICA IN THE U. STATES. 103 

Other points which will require investigation are the part or 
parts of the plant most effective, its relations to the usual menstrua 
employed in pharmacy, as water and alcohol, the best mode of ad- 
ministration, and the dose. Its composition and general chemical 
relations are also important objects of inquiry ; but few medical 
men, and none who have not devoted a special attention to prac- 
tical chemistry, are capable of conducting successfully those com- 
plex and delicate processes which are essential to accurate analy- 
sis, especially of organic products. This part of the investigation 
may, therefore, with propriety, be left to the pharmaceutical che- 
mist, within whose province it strictly falls. 

To complete your work, it will now only remain to record the 
results of your investigations. In doing this, your rule should be 
to put down everything exactly, plainly, and in as few words as 
possible consistently with perfect clearness. Your object will not 
be to produce an impression by means of rhetoric, but to establish 
facts in science ; and these are always most striking in their native 
simplicity. We suspect the purity of truth herself, when she is dis- 
guised in meretricious ornament. You should endeavour in your 
narrative to present to the reader, in their proper order, all the 
materials for forming a judgment of which you may be yourselves 
in possession, and thus enable him to come to the conclusion you 
desire, perfectly satisfied of its correctness. No matter whether 
your inquiries have ended in the discovery of some new fact, or the 
refutation of some old error ; in either case the result is truth, and 
the process by which it was attained is equally deserving of re- 
cord. But be not in haste to publish your essay after you have 
prepared it. An author is seldom a good judge of his own pro- 
ductions when immediately from his pen. He views his offspring 
with a paternal, I might, perhaps, be allowed to say, with a mater- 
nal eye, which can see no defects, and often finds beauties when in- 
difference would discover only deformity. Lay aside your manu- 
script for a time ; let the ardour of composition cool, the pains of 



104 HISTORY OF MATERIA MEDICA IN THE U. STATES. 

your mental labour be forgotten; you will then be able to judge of 
your own production more as a critic than as an author ; and you 
may depend upon it that you will find much to amend, and rejoice 
that you have yet the power. 

I have thus, gentlemen, accomplished the object which I pro- 
posed at the beginning of the lecture. Much more might have 
been said on almost every point, and perhaps not unprofitably, had 
time and space permitted; but in this world of limited power and 
limited opportunities, one great secret of doing well is to take a 
just view of the power and opportunity we actually possess, and 
adapt our aims and efforts accurately to them. This at least I 
endeavour to make a rule of action for myself; and you will find 
me governed by that rule in the subsequent course of lectures. 
We have only a certain amount of time allotted to materia medica. 
In arranging my course, I have endeavoured to find the just pro- 
portion between the importance of the several topics and the whole 
time, and to devote to each topic its due share of consideration, so 
that none may be entirely neglected. If I am thus induced to say 
less than lecturers often do upon certain prominent subjects, I have 
at least the advantage of giving some attention to others, which, 
though severally less important, are much more so in the aggre- 
gate. My great object is to give the pupil opportunities for ac- 
quiring such a knowledge of principles and facts, as may serve for 
a basis to his own future labours. To render these opportunities 
available, your zealous co-operation will be requisite. Judging 
from the experience of the past, I have no doubt of such co-opera- 
tion. I have not yet had occasion to complain of the want of due 
attention on the part of a class, and entertain no apprehension 
that, at the termination of the present course, I shall have cause 
to express a different sentiment. Should my efforts equally con- 
tent your reasonable wishes, my ambition will be satisfied. . 



LECTURE III. 

DELIVERED NOVEMBER 5th, 1844. 



Importance of. Materia Mediea. 

Among those now present are many to whom everything around 
them is familiar. There are also many to whom the occasion, the 
place, and the speaker, are equally new. The former I count as 
friends already, and welcome them cordially and affectionately back 
to our old relations. The latter I hope to rank among my friends, 
when a short intercourse shall have made us mutually acquainted ; 
and, in the mean time, would extend to them my kindest greetings, 
with the assurance that I have sincerely at heart their best welfare 
in all respects. 

My present duty is to introduce, and recommend to your favour- 
able attention, the study of materia mediea. This department of 
medicine has been somewhat undervalued in later times. Patho- 
logy, in itself so copious, has been forced by peculiarly fostering 
influences into a luxuriance of growth, which has somewhat over- 
shadowed the other branches of our science. Policy, moreover, 
has led to the representation of materia mediea as inferior in prac- 
tical importance, and scarcely worthy of any peculiar diligence 
either in teaching or learning it. This policy has, no doubt, coin- 
cided with honest convictions; for the objects of our own indi- 
vidual pursuit swell, almost unavoidably, into a magnitude which 
throws all others into the shade. In asserting and maintaining an 

(105) 



106 IMPORTANCE OF MATERIA MEDICA. 

opposite view, I may be accused of acting under similar influence. 
I admit the charge to a certain extent; but there is this obvious 
difference, that, whatever may be my regard for the science which 
has constituted one of the chief objects of my life-long labour, I 
arrogate for it no superiority; I claim for it only equality with its 
sister sciences. Upon this footing, gentlemen, I wish to place it 
in your estimation ; in order that your dispositions towards it may 
not be rendered lukewarm, nor your exertions in its cultivation 
slacken, under any false views which may have been, or may still 
be presented to you, of its inferior relative value. 

The great object of the physician is to restore health to the 
sick. Everything is important to him which contributes to that 
object; and, of two things both of which are essential, it can 
scarcely be said that one is more important than the other. If 
it be necessary to understand disease, it is no less necessary to be 
acquainted with the means of cure. This would seem to be a self- 
evident proposition. The question, then, to be decided, is simply 
this ; are medicines, which, viewed in the aggregate, and in all 
their different relations, constitute the materia medica, necessary 
to the cure of disease ? I know that some are, or profess to be, 
skeptical on this point. They have more confidence in the regula- 
tion of the diet and modes of living ; in the diversified application 
of temperature, moisture, and air ; in mental influences ; in deple- 
tion by leeches or the lancet; and in other remedial means of a 
similar nature. Now, admitting the importance of these means, 
and disregarding the consideration that, in its amplest sense, the 
science of materia medica may be said to embrace them, are you 
prepared to reject medicines, strictly so called, as essential in the 
treatment of disease ? Is it probable that the experience of forty 
centuries is utterly deceptive ; that all the labour, skill, and science, 
which have been expended in collecting, investigating, preparing, 
and applying medicines, have been quite thrown away; that, at 
the present time, almost the whole body of our profession, cer- 



IMPORTANCE OF MATERIA MEDICA. 107 

taiuly not behind the highest in native talent, acquired knowledge, 
and sound judgment, are icily wasting their time in the pursuit of a 
mere ignis fatuusf Would it not imply an impertinent self-con- 
ceit to set up one's own single opinion, without the support of fact 
or reason, against this experience of all past time, this world-full 
of present conviction ? But let us turn to individual instances ; 
for single examples sometimes outweigh all general influence in 
their impression on our faith ; and one solitary case, brought be- 
fore the mind's eye, gains for a truth a more ready acceptance by 
the understanding, and a firmer seat in the memory, than a thou- 
sand arguments addressed only to the reason. 

Enter with me into an infirmary, and examine a few of the cages 
which offer themselves to the spectator. On that bed sits a man, 
who, less than a week ago, came into the ward pale, sallow, and 
emaciated, worn out in health and spirits, with a disease which 
had been hanging about him for weeks, perhaps for months, inca- 
pacitating him for labour, and rendering his life wretched. His 
complaint was a protracted intermittent. From twelve to twenty- 
four grains of sulphate of quinia cut it short in one day ; and he is 
now a well man, eager to enter once more upon the duties and 
enjoyments of life. 

In this other bed lies a patient, recently from the Southern coast 
of our own country. He is in the second paroxysm of a pernicious 
intermittent. His pulse is beating with great rapidity; his ex- 
tremities are cold, while he complains of intense heat and thirst ; 
his countenance is sunken, anxious, almost haggard ; the hand of 
death is apparently upon him; but he has one chance of life. 
The period for the spontaneous subsidence of his paroxysm is at 
hand ; and the probability is that he will survive it. But the third 
paroxysm, should it seize him, will prove inevitably fatal. A leap 
into the Falls of Niagara would not be more so. What then is to 
save him ? Will the lancet ? Will regimen ? Will heat or cold ? 
Will any form of application into which water can be tortured 



108 IMPORTANCE OF MATERIA MEDICA. 

save him ? No, gentlemen, not one, nor all together. No earthly 
power can check his headlong descent to the grave, except only- 
one, and that, the power of a medicine. Let sulphate of quinia be 
given to him freely, and it will almost certainly rescue him. I can 
promise you this with the confidence of repeated experience. 

Passing onward in our round, we come to a patient universally 
swollen with dropsy. Scarcely a trait of his countenance, or a line 
of his form remains. Unless relieved, he must speedily go to his 
long home. But he has been taking digitalis for several days. It 
has begun to exhibit its effects upon his kidneys. In a short time, 
this bloated mass of disease will have melted away before its in- 
fluence, like snow before the sun. The patient will have been 
saved by a medicine. 

Here is a case of bilious remittent cut short by an emetic ; there, 
another of chronic bronchitis getting well under seneka. Proceed, 
and you will see cases of syphilitic rheumatism, scrofulous ulcers, 
and anomalous cachectic eruptions, yielding to iodine ; inveterate 
and most offensive diseases of the skin, to arsenic; and chronic 
inflammations of all kinds, to mercury. 

I might thus conduct you through every ward in the hospital; 
not, indeed, with the same uniformly favourable results, but still, 
with illustrations all around us of the palliative or curative power 
of medicines. In oar ordinary, every-day practice, how often do 
we see croup yield instantaneously to an emetic ; violent stomachic 
spasm to an antacid and carminative ; colic and diarrhoea to a 
cathartic ; pain, restlessness, and want of sleep to opium ; and 
spasmodic cough to assafetida; not to mention any of those almost 
innumerable instances, in which, by skilful combination and diver- 
sity in the application of medicines, the most hazardous and threat- 
ening diseases are triumphantly conducted to a favourable issue. 
I could easily occupy the whole lecture with such an enumeration. 
Believe me, gentlemen, there are substances in the catalogue of 
the materia medica, essential not to our comfort only, but also to 



IMPORTANCE OF MATERIA MEDICA. 109 

our safety, and the loss of wliich would be wholly irreparable for 
humanity. 

You are, I think, prepared to admit the indispensable necessity 
of medicines in the treatment of disease, and, consequently, the in- 
dispensable necessity of understanding them. No man can be 
other than a bungling practitioner of medicine, without an ac- 
quaintance with the science of materia medica. 

But it may be said that, admitting the importance of certain 
prominent medicines, the number of those really valuable is very 
few; and that the study of the remainder is merely a waste of 
time. Ignorance and idleness are, for the most part, the parents 
of this very convenient notion. For one unacquainted with medi- 
cines, and too indolent to acquire a knowledge of them, it serves 
as an easy refuge from the inflictions of his own conscience, and 
the evil opinion of his fellow-men. False hypothesis comes hap- 
pily to his aid, and may even generate an enthusiastic devotion to 
what was originally the mere creature of sloth. Sangrados have 
existed in every age. " Give me opium and the brandy-bottle," 
says one enthusiast; "give me calomel and the lancet," says 
another; "and I will fearlessly encounter disease." But, gentle- 
men, disease listens to the vain boast, and laughs in his sleeve. 
He knows well that a wind-mill, or a flock of sheep, may suffer in 
an encounter with such Quixotes in medicine ; but that he himself 
has little to fear. 

But men of a higher grade of character, honest searchers after 
truth, have been led into a similar error. The human mind, in its 
vain aspirations after universality of knowledge, struggling to em- 
brace the infinite within its finite capacity, seizes eagerly upon 
grand generalities, which may serve to involve a host of individual 
facts, and thus immeasurably to extend its powers of acquisition 
and retention. This is, no doubt, the correct course, if followed 
with due caution ; with the utmost care to admit no general truth, 
until firmly established by a due series of inductions from admitted 



110 IMPORTANCE OF MATERIA MEDICA 

facts. But our impatience is constantly overleaping this barrier; 
and, to avoid the labours of research, we have recourse to inspira- 
tion. A bright thought flits across the fancy of some man of 
genius. He seizes the unfledged idea, cherishes it with solicitous 
care, and, when sufficiently amplified and adorned, with brilliant 
plumage and expanded wings, exposes it to the astonished gaze of 
the multitude, and claims for it their homage, as for a messenger 
from on high. 

Hypotheses of this sort we have had in medicine, and, among 
them, one which had for a time great influence in the spread of the 
very error we are now combating. Yital power is a unit ; vital 
action, being nothing more nor less than the exercise of this 
power, is also a unit ; derangement of this action, possible only in 
grade, is another unit; and the measures of relief, being merely 
such as lower the action when elevated, and raise it when de- 
pressed, must have the same unity of character. A scanty materia 
medica is the necessary pendent to this chain of argumentation. 
Born with Brown, adopted and amplified by Rush, and appropri- 
ated with modifications by Broussais, this hypothesis, in one shape 
or another, long exercised a powerful influence in the medical 
world. It was set up, like another golden image, by the despotic 
French reformer, who issued his edict that all the world should fall 
down and worship it, under the penalty, if disobedient, of being 
cast into "the burning fiery furnace" of his indignation. And 
great multitudes did fall down and worship. Neither were Shad- 
rachs, Meshachs, and Abed-negos wanting, who refused obedience 
to the decree, and yet escaped unhurt the flames of the seven-times 
heated furnace. But Nebuchadnezzar has fallen ; and the image 
is broken ; and the worshippers are reduced to a few, who, dwell- 
ing in the outskirts of the medical world, are scarcely yet aware 
that the great chief is gone, after surviving the revolt of almost all 
his partisans, and the demolition of his strong-holds. Yet the 
hypothesis has left behind it, in the minds of many who no longer 



IMPORTANCE OF MATERIA MEDICA. Ill 

recognize its truth, vestiges of its sway, which are observable 
in their modes of practice, and their estimate of our particular 
branch of medicine. Wanting, as they supposed at the outset of 
their professional voyage of life, but few remedial means, and those 
of the simplest kind, they neglected to provide themselves with a 
knowledge of many usually deemed important; and now, when, 
perhaps, experience has thrown some doubt over their previous 
opinions, they find it inconvenient if not impossible to check their 
onward course, and turn their sails backward for a more ample 
supply. They must content themselves with their poverty ; while, 
before the multitude, they conceal it under the cloak of philosophy. 
Unable fully to avail themselves of the riches clustering about the 
materia medica, they find the grapes sour, and make faces before 
the inexperienced as if their teeth were on edge. 

Now, gentlemen, I would put you on your guard against such 
representations. I would prove to you that not only are medi- 
cines, speaking in general terms, essential, but that it is important 
to be provided with numbers of them, possessing various powers 
and properties, in order to meet the diversified calls of disease. 
In the first place, I would tell you that experience has sufficiently 
established the fact. The present treasures of our materia medica 
have, for the most part, undergone the careful scrutiny of ages. 
Medicines are often hastily introduced into notice upon insufficient 
grounds, and attain, for a considerable time, an undeserved popu- 
larity. But at length they are sure to find their proper level, and, 
indeed, not unfrequently sink below it. If altogether worthless, 
they are rejected, and at length forgotten; or, at best, retain a 
place in the collections of the curious, as memorials of the past. 
It may, therefore, be taken for granted, that those which hold their 
position in our officinal catalogues, after having passed the ordeal 
of time, are deserving of that position. There may be some, of 
recent origin, which are admitted in reference to their present 
popularity, and which may hereafter be excluded ; there may, 



112 IMPORTANCE OF MATERIA MEDICA. 

moreover, be preparations, which will hereafter be superseded by 
others better calculated to answer the same end ; but even these 
are not exceptions to the general value of the catalogue for the 
learner; for every physician should know something not only of 
medicines which he values himself, but of those also which are 
valued and used by those about him; and preparations which may 
some time be improved, are essential to us until the period of that 
improvement shall arrive. 

But let us reason a little upon the point. We know that medi- 
cines not only differ in their effects upon the system at large, but 
that they also have peculiar tendencies to particular parts or 
organs. A medicine which acts on one organ, may produce no 
effect on another; and there is scarcely an organ in our constitu- 
tion, for which there is not this special affinity on the part of some 
one or more medicinal substances. Need I refer you to particular 
instances? Need I tell you that, while quinia, and mercury, and 
iron, and iodine, all act, to a certain extent, upon the whole system, 
and in modes peculiar to each, ipecacuanha will act upon the stom- 
ach, castor oil on the bowels, squill upon the kidneys, citrate of 
potassa upon the skin, cantharides upon the generative organs, 
opium upon the brain, digitalis upon the heart, and so on through 
nearly the whole series of medicines and of organs ? Now, diseases 
seated in these different parts are sometimes to be reached only by 
the remedies acting on these parts specially; and there is, besides, 
not an organ which may not occasionally be beneficially called into 
action, in order to remove disease seated in another organ, or occu- 
pying the whole system. Here, then, is one ground for the use of 
numerous medicines of diversified relations. 

Different medicines, moreover, affect differently the same part or 
system of parts; some exalting, others depressing, and others, 
again, in some unknown way modifying, its actions. Diseases 
having the same diversity, in the same positions, must conse- 
quently call for these diversified powers in medicines. When the 



IMPORTANCE OF MATERIA MEDICA. 113 

heart is excited, it requires to be depressed; when depressed, to 
be exalted ; when irritated, to be soothed ; when enlarged, to be 
contracted ; and there are substances, capable, to a certain extent, 
of meeting these several requisitions. The same remark may be 
extended to all the vital organs; and thus another ground is 
offered for the multiplication of medicines. 

Remedial substances of the same general mode of action possess 
very different degrees of power, adapting them to various grades 
of severity in disease. To use only the most powerful, in all cases, 
would be like employing a wood-chopper's axe, or the scythe of a 
mower, to shave with ; like shooting a squirrel with a twenty-four 
pounder. It may be said that every desirable grade of activity can 
be obtained by duly proportioning the dose. But this is a mis- 
take. The stomach would not hold enough of some of the milder 
medicines to produce the effects of the strongest; and, in relation 
to some of the more powerful, though you may quite annihilate 
their action by a sufficient reduction of the dose, you cannot sub- 
due their violent nature. The hyena and tiger may be confined or 
prostrated by superior power; but you cannot tame them. So 
long as they can act at all, they will act according to their savage 
instincts. Who would think of administering croton oil, or elate- 
rium, to accomplish what might be readily effected by a Seidlitz 
powder, or a dose of magnesia ? The necessity, then, of having 
medicines graduated, on the scale of activity, to the severity of the 
disease, or the degree of effect required, must lead to a great ex- 
tension of the catalogue. 

Nor is this all. There are peculiarities in the constitution of 
certain individuals, called technically idiosyncrasies, which render 
them wholly rebellious to means that may be admirably adapted 
to ordinary cases. The vulgar proverb, that "what is one man's 
meat is another man's poison," is expressive of a sober truth in 
medicine. To meet such idiosyncrasies, it is highly important to 

8 



114 IMPORTANCE OF MATERIA MEDICA. 

have different medicines of analogous remedial powers; so that, 
if one should disagree with a patient, we may have recourse to 
another. 

Again, there are peculiar tastes, likes and dislikes, and even 
prejudices, which it is necessary to consult, if we desire to accom- 
plish the greatest good. Some persons, for example, prefer Glau- 
ber's to Epsom salt ; others, who dislike both these medicines, even 
to nausea, are unaccountably fond of castor oil ; and, strange as it 
may seem, there are not a few individuals who have an exceeding 
relish for those most nauseating drugs, rum and tobacco. Now, 
though I would not so far gratify this peculiarity of taste, as to 
allow of the habitual use of these favourite substances in health, 
yet, in disease, they might constitute a valuable resource, when 
others of analogous powers might happen to be offensive. The 
young practitioner, in his pride of science and profession, is apt to 
be a little despotic, and inclined to force medicines on his patients 
against the stomach of their sense ; not to speak of their morbid 
squeamishness and their prejudices, which frequently rise up against 
his prescriptions. When his end can be attained by no other 
means, it is quite proper that he should be thus firm ; but when, 
by the number of medicines at his command, he has it in his power 
to accomplish the same object by means equally efficient, and more 
acceptable to the patient, it becomes his duty, as it undoubtedly is 
his interest, to avail himself of them, and thus avoid the disturb- 
ance of system which is so apt to result, in the sick, from a contra- 
vention of their feelings and wishes. The more ample his list of 
medicines of real efficiency, the better able will he be to meet this 
demand upon his resources. 

Beside medicines in their simple or crude state, there are nume- 
rous preparations which serve to swell the catalogue for the learner. 
By various modes of chemical or pharmaceutical treatment, changes 
are effected in the remedial qualities, strength, durability, or con- 
venience for administration of medicines, which are in the highest 



IMPORTANCE OF MATERIA MEDICA. 115 

degree important, and cannot be neglected by the practitioner with 
impunity. Substances are thus rendered mild or energetic, at the 
discretion of the operator; acceptable to the palate and stomach, 
when they might otherwise be offensive to both ; capable of being 
preserved without change indefinitely, instead of undergoing speedy 
decay ; and, finally, remedial in modes altogether unknown to them 
in their native state. Need I mention, as illustrations, quinia from 
Peruvian bark ; morphia from opium ; calomel, corrosive sublimate, 
and the blue mass, from mercury ; tartar emetic from antimony; and 
the various compounds of iron, and of iodine? It is sufficient to 
say that the number of medicines is much more than doubled in 
this way. 

If, then, medicines are essential to the practitioner, and at the 
same time numerous ; and if they require to be understood in order 
to be duly employed ; how can materia medica, which teaches their 
properties and powers, and the modes of applying them, be other- 
wise than an important science ? How can it be postponed, with 
impunity, to the other branches, in a course of medical instruc- 
tion ? 

But you may be told that the knowledge of medicines may be 
easily acquired; that nothing more is requisite than a moderate 
exercise of the organs of smell, taste, and vision ; and that lectures 
are scarcely wanted upon so simple a subject, an acquaintance with 
which may be taken, almost in the natural way, by a short exposure 
to the odours of an apothecary's shop, or the office of a country 
physician, like the measles or sinall-pox, in the sick chamber, or 
the wards of an hospital. This, gentlemen, would be the language 
of imbecility, infatuation, or fraud. Let us inquire briefly what it 
is necessary to know of medicines, and then decide whether the 
knowledge is likely to come easily and without aid. 

In the first place, what preliminary knowledge is necessary ? In 
answer to this question it may be stated, that, independently of the 
ordinary information which should serve as the basis of all profes- 



116 IMPORTANCE OF MATERIA MEDICA. 

sional studies, the learner in materia medica should have acquired 
a considerable proficiency in chemistry, and a general acquaintance 
with anatomy and physiology. The former is necessary to enable 
him to understand the nature and mutual relations of medicines, 
the principles upon which they are prepared, and, to some extent, 
their modes of acting in disease. Chemistry is, indeed, chiefly 
useful in our profession as the handmaiden of materia medica. 
Without anatomical and physiological knowledge, the student could 
not understand the all-important relations of medicines to the sys- 
tem ; for how could he appreciate the changes pro'duced by them 
in the organs and functions of the body — changes which constitute 
almost exclusively their remedial influence — if ignorant alike of 
these organs and functions? You perceive, then, that no little ex- 
penditure of time and labour is necessary in laying even the foun- 
dation of materia medica. Is it reasonable to suppose that a 
superstructure, requiring so broad a basis, can itself be of trifling 
magnitude ; that, founded so laboriously, it can be built up without 
rule, and without effort ? 

We have seen what preliminary knowledge is necessary. Now 
let us see what should be known of medicines themselves. To be- 
gin at the beginning, we should not be ignorant of their origin, 
the places where they are produced, the modes in which they are 
fitted for the market, the routes by which they reach us, and the 
state in which they are obtained from the merchant, before being 
prepared for the office of the practitioner, or the shop of the 
apothecary. All this knowledge is not absolutely necessary to the 
physician, but it is highly useful in various ways. It enables him 
to appear advantageously, in many instances, before the world ; to 
avoid the imputation of ignorance in essentials, which might be 
cast upon him by persons capable of appreciating any failure in 
these minor points ; to escape frequent impositions in the purchase 
of drugs, should this enter, as it often may do, into his professional 
avocations ; and, finally, to enjoy that internal satisfaction which 



IMPORTANCE OF MATERIA MEDICA. 117 

accompanies the possession of all kinds of useful knowledge, and 
especially of that which is in harmony with his every-day pursuits. 

Even the names of medicines will be found by the student to be 
some burden upon his industry ; and yet, with the knowledge of 
these he cannot possibly dispense. It is not only one name for 
each medicine that he is under the necessity of learning. He must 
know also the most common synonymes ; for how otherwise could 
he understand the works in which they are employed, or even the 
conversation of a medical brother, who might happen to use a dif- 
ferent name from the one most familiar to himself? What would 
you think of a physician, who should not be aware that sulphate of 
magnesia is only another name for Epsom salt, mild or proto- 
chloride of mercury for calomel, nitrate of silver for lunar caustic, 
and so on through a long list of medicines ; not to speak of the 
Latin synonymes, which are so much employed in published trea- 
tises, and so constantly the language of prescriptions, that a physi- 
cian ignorant of them would be liable to the most ludicrous, as 
well as to the most serious blunders? 

It is scarcely necessary for me to say that the student should 
make himself familiar with the sensible properties of medicines, 
such as their general appearance, colour, taste, smell, and consist- 
ence; as it is only thus that he can recognize them when brought to 
his notice. The most dangerous mistakes might arise from the want 
of this knowledge. One of an unpleasant, and yet ludicrous char- 
acter, fell under my own observation. A physician was consulted 
as to the nature of a liquid, of which a gentleman had swallowed 
argely, supposing it at the time to be a solution of Epsom salt, 
though afterwards led, by what cause I do not recollect, to enter- 
tain some doubts upon the subject. After having tasted it, the 
physician pronounced it to be a solution of nitre. Great conster- 
nation was, of course, created ; as sufficient had been taken to 
prove fatal, should this opinion be correct. The patient experi- 
enced an alarming coldness at his stomach, with other disagreeable 



118 IMPORTANCE OF MATERIA MEDICA. 

abdominal symptoms, and no little disturbance of his nervous 
system. An emetic, however, of ipecacuanha, by evacuating the 
stomach of the offending cause, gave speedy relief; and perfect 
recovery was quickly established. Next day, the messenger who 
had procured the poison was taken to the apothecary's shop where 
it had been purchased, and, having had his attention directed to 
two parcels of medicine, one consisting of Epsom salt, and the 
other of nitre, was told to point to the one most nearly resembling 
that from which so much mischief might have resulted. Without 
hesitation he designated the former ; and thus it appeared that an 
innocent dose of salts had been mistaken for a substance of dan- 
gerous activity, and a gentleman been put into the awkward posi- 
tion of exhibiting various imaginary symptoms of poison, with the 
anxiety and perturbation incident to such an occasion, and after- 
wards learning that all this, as well as the nauseous dose of medi- 
cine he had taken, might have been spared, had the physician pos- 
sessed a more discriminating taste. 

It is not, however, sufficient to be acquainted with the sensible 
properties of medicines. Those having reference to their chemical 
relations are not less important. Without a knowledge of these, 
medicines of the most incongruous character might be adminis- 
tered together, with the effect of diminishing, increasing, or alter- 
ing their activity, so as, in either case, to disappoint the expec- 
tations of the practitioner, and sometimes to lead to the most 
disastrous results. No longer ago than last winter, a young mem- 
ber of the class inquired of me, what would be the effect of mixing 
together calomel and nitromuriatic acid. I told him probably to 
form corrosive sublimate. " Then," said he, " I can account for 
the result of a terrible case, in which considerable quantities of 
these two medicines were given simultaneously, and the patient 
died with symptoms of violent gastroenteritis." This case is not 
solitary. Many similar results of incompatible prescription are 
undoubtedly covered over by the cold sod ; not even the practi- 



IMPORTANCE OF MATERIA MEDICA. 119 

tioner himself being aware of the mischief he has done. The pre- 
paration of medicines for use demands the same knowledge of their 
chemical relations ; the effects upon them, for example, of heat, 
air, and moisture, of the implements employed in operations upon 
them, of the liquid or other vehicles with which they may be 
mingled, of the various circumstances, in fine, which attend their 
administration. Then, some medicines lose their efficacy when 
heated, others when exposed to air and dampness ; some are in- 
jured by contact with metals which are not affected by glass or 
earthenware ; and those which may be safely and conveniently pre- 
pared with one liquid or powder are often wholly incompatible 
with another. You must readily perceive how numerous may be 
the errors on these various points, and how great the inconveni- 
ence, not to say mischief, resulting from ignorance. 

But there is another set of relations still more important ; those, 
namely, which medicines bear to the system in health and disease. 
Upon these is based their whole therapeutical application; and, 
without a knowledge of them, so far as they have been investigated 
and established, no man can have a claim to be considered a 
rational practitioner. It is not sufficient to have learned that one 
medicine is adapted to one disease, another to another, a third to 
a third, and so on. This sort of knowledge would lead to a purely 
empirical practice, in which the physician is only a sort of machine 
for executing certain prescribed movements ; a hearing and seeing 
automaton, which, at the name of bile, picks up calomel, and at 
the sight of fever or inflammation or hemorrhage, seizes the lan- 
cet. Most medicines have modes of affecting the system more or 
less peculiar to themselves ; and diseases, as they are presented to 
our notice, consist usually of a combination of various functional 
or organic derangements, to each of which some one of the medi- 
cinal actions may be especially adapted. Now, you must be sen- 
sible that, in order to a rational application of the medicine, both 
its own proper action, and the derangement of system for the cure 



120 IMPORTANCE OF MATERIA MEDICA. 

of which this is suited, must be well understood. The former 
knowledge belongs to the department of materia medica, the latter 
to that of pathology. Here, then, is a wide field for the learner, in 
which he must labour much before he can master what is known, 
and in which, after all, there is yet a vast deal to be discovered in 
the progress of time and research. 

Besides all the knowledge in relation to medicines which has 
been already indicated, there yet remains that of the art of pre- 
paring them. This belongs strictly to the pharmaceutist ; but no 
physician can be safely altogether ignorant of the principles of the 
art ; and, as medicine is practised through the greater portion of 
our country, not only the principles, but the actual processes and 
manipulations should be familiar to the practitioner. What would 
be thought of a country physician, who could not prepare a tinc- 
ture, or infusion, or mixture, or pill, who should not even under- 
stand how to weigh out a dose of medicine, or to apportion liquids 
by proper measures ? and yet all these acts require considerable 
knowledge and skill for their due performance. 

You see then, gentlemen, that the science of materia medica is 
of no trifling importance, of no inconsiderable extent, of no easy 
and unlaboured acquisition. He who tells you differently deceives 
you ; and should you now listen to his seductive voice, the time of 
repentance will assuredly come. When involved in the serious 
responsibilities of your profession, with the sick and the dying 
around you imploring for relief and safety ; how will you feel, if, in 
the anxieties, the agitations, the eager and trembling wishes and 
fears of the moment, you see the danger, and know that means of 
salvation exist, but cannot tell where to find them ; if, standing on 
the tempestuous shore, and beholding the fellow-beings you are 
bound to protect, tossed about and vainly struggling in the terrible 
flood, you are compelled to look idly on, because unprovided with 
the life-boat which might save them ? 

There yet remains one point of our subject to be disposed of. 



IMPORTANCE OP MATERIA MEDIC A. 121 

Admitting all that I have said to be true, you may ask, and the 
question has been asked, is the aid of a lecturer necessary to guide 
and facilitate your studies ? I will not say that such aid is abso- 
lutely indispensable. On the contrary, I know that, by a due pre- 
paratory course of study, by the industrious perusal of works upon 
materia medica and pharmacy, by a diligent attendance in the 
shop of an apothecary, and, after all this, by a course "of practical 
experience in the treatment of diseases, sufficient to assure you of 
the relative value of the different precepts you may have found in 
the books, you may at last come out accomplished scholars in this 
branch of medicine, without the assistance of those who have trod 
the same path before you. But, in the pursuit, you will have suf- 
fered many perplexities, have applied much painful labour, and 
expended much valuable time, which might have been spared, had 
the hand of experience been present to guide you. In regular 
treatises upon this, as upon all other sciences, there is much that 
is of comparatively little value to the learner; much that is in- 
troduced merely to complete the system, or to serve as matter of 
reference when required for any special purpose, whether of 
curiosity or usefulness. The whole is too great a burden for any 
memory ; and, even if the memory were capacious enough to re- 
ceive and retain it, mischief would ensue from the necessary exclu- 
sion of more important facts, belonging to other departments of 
knowledge ; for all human capacity is finite. But how is the 
learner to know which are the important points unless informed ? 
How will he be able to select the wheat and leave the chaff, unless 
he can distinguish between them ? We have no winnowing ma- 
chines which will perform this duty for him. He must either de- 
vour the whole, with the danger of nausea and repletion, or must 
select a part, with the risk of choosing the least valuable, and 
neglecting what is most important. A lecturer will perform this 
office of selection for him much better and more effectually than he 
could perform it for himself. The remark, it is true, applies to 



122 IMPORTANCE OF MATERIA MEDICA. 

the mode of instruction in most of the sciences ; but it is especially 
applicable to ours ; for in scarcely any are the isolated facts, out of 
which a selection must be made, so exceedingly numerous. 

Another advantage of lectures is to serve as a sort of arbitra- 
tion between conflicting statements or opinions, which equally 
press upon the notice of the learner, and claim the right to be 
adopted. One author says one thing, another says another, and 
the two are often conflicting. How is the student to make a 
choice between the two bundles of hay, each one of which seems 
equally attractive ? His best plan is to put himself under the 
direction of a more experienced individual, in whom circumstances 
may have induced him to place confidence ; and to follow his lead, 
until sufficiently advanced to be able to form a judicious opinion 
for himself. He may sometimes, possibly, be led into error ; but 
this he can afterwards correct, when his opportunities extend, and 
his judgment becomes matured ; and, at any rate, it is better to be 
mistaken in some points, than to be constantly floundering about 
in uncertainty, with anxious but vain efforts to attain some fixed 
ground upon which to stand. 

Another strong reason for lectures on materia medica, is that it 
is strictly a demonstrative branch of knowledge. At least, as such 
I have always taught, and still continue to teach it. There is 
scarcely one of its departments, excepting that of therapeutical 
application, which does not admit of practical illustration in a 
course of lectures. It may, in this respect, almost take a position 
by the side of anatomy and chemistry, which, you are aware, are 
pre-eminently the demonstrative branches of medical science. 

I appeal to you now, gentlemen, if I have not established the 
propositions, in relation to our science, which were the starting- 
points of this lecture. Are you not convinced, not only that ma- 
teria medica is important, extensive, and worthy of your best 
efforts to master it ; but that lectures upon the subject may be of 
great, almost indispensable value to the learner? But I do not 



IMPORTANCE Or MATERIA MEDICA. 123 

wish you to be alarmed. There are no difficulties about it which 
are insuperable, none which diligence may not overcome if pro- 
perly guided and supported. I am entirely sure that I can make 
it much easier for you than you would find it without aid. Nor 
do I expect impossibilities from the student. I know his limited 
time ; in many instances, his limited opportunities ; and can make 
the requisite allowances. All that I ask from him is an earnest 
effort to master the subject, and a disposition to make the most of 
the opportunities offered him. I promise you my best aid ; and I 
do so, not merely in the cold formality of official duty, but with the 
most friendly dispositions, with the anxious desire to facilitate 
your labours, and to witness your success. 



LECTURE IY. 

DELIVERED NOVEMBER 6th, 1S37 



Abuses to which the Materia Medica is liable in Practice. 

Gentlemen : — 

I should be doing injustice to my feelings, were I to enter at 
once upon the business for which we are met together, without a 
kindly greeting to the many old friends whom I recognize among 
you, and a hearty welcome to those yet unknown to me, whom I 
hope to see no less my friends before we part. 

You are about to enter on a toilsome pursuit, and have applied 
to our greater experience for aid and counsel. These it is our 
duty to afford you ; and it becomes us to consider in what way 
they may be imparted most effectually for your good. It is not 
sufficient to lay before you the bare materials of knowledge, to be 
connected and fashioned as your own taste and judgment may dic- 
tate. Nature, whether moral or physical, seldom presents her ele- 
ments in an isolated state. She variously combines them, arranges 
the results of her grand chemistry in numberless shapes of use or 
ornament, invests each individual existence with infinitely diversi- 
fied relations, and, by an invisible cord of union, binds all her vast 
materials, however apparently discordant, in one great and har- 
monious whole. Science is nothing more than the interpretation 
of nature. Each department of knowledge, or of art, is but one of 
the sections of her boundless dominion. Instruction, to be perfect, 
(124) 



ABUSES OP THE MATERIA MEDICA. 125 

must be a copy of her works. The branches of study which are to 
engage your attention are all shoots of the same great trunk, and 
obedient to the same laws. In our endeavours, therefore, to teach 
you, we should aim always at an approach to nature. We should 
present you with the elements of knowledge ; but we should also 
make you familiar, so far as our own short-sightedness can pene- 
trate, with all their combinations and relations having any bearing 
upon your pursuit. Such is the principle which will guide me in 
teaching materia medica. My intention is not only to introduce to 
your notice individual medicines ; but also to treat of them in all 
their bearings ; to give you at least a sketch of all those various 
courses of action and opinion in which they constitute essential 
objects. With these intentions, I cannot pass over unnoticed the 
ibuses to which medicines are liable. 

It is the tendency of addiction to any one pursuit, to magnify its 
idvantages, and, in an equal degree, to underrate its attendant 
evils. There is little danger that a teacher of materia medica will 
fail sufficiently to impress upon the student the importance of medi- 
cines ; there may be some, that he will turn to his audience exclu- 
sively the bright side which he loves to contemplate himself, and 
neglect to put them upon their guard against the perils to which 
they are exposed. I shall endeavour to avoid this error; and, 
though unwilling to damp your ardour by instilling unnecessary or 
fanciful apprehensions, shall not shrink from the duty of pointing 
out dangers, whenever I may myself be aware of their existence. 
Much that has relation to the misuse and abuse of medicines may 
be most advantageously reserved for the occasion when each medi- 
cine is to be individually considered ; but I do not know that I can 
lo better than avail myself of the present opportunity, to offer some 
views of a general nature, which may possibly be found useful, at 
the same time, in guarding you against errors yourselves, and in 
enabling you to counteract, in some measure, the mischief resulting 
from the errors of others. In order to render the subject clearer 



126 ABUSES OF THE MATERIA MEDICA. 

and more impressive, I shall endeavour to arrange, in a regular 
series, the various sources of error in the employment of medicines, 
so far as I have been able to discover them, giving precedence to 
the least copious, and reserving for the close such as send forth 
their flood of evil most abundantly. 

Physicians, even though well instructed, particularly those young 
in the profession, are apt to attach undue importance to the influ- 
ence of medicines, not sufficiently considering the character of the 
pathological condition, nor how impossible it often is to effect salu- 
tary changes in this condition by other means than the slow ope- 
rations of nature. Administering a remedy in some complaint in 
which it may appear to be indicated, and not finding a degree of 
amendment equal to their impatience, they are tempted either to 
increase the dose too rapidly, and thereby incur the risk of seriously 
complicating the disease, or to resort prematurely to other really 
less eligible means. They are, moreover, under the constant in- 
ducement to prescribe medicines, where patience and the careful 
avoidance of perturbating agencies are all that is necessary to the 
cure ; and there can be no doubt, that the thread of life has often 
been snapped by the officious hand of the physician, rashly thrust 
into the deranged vital process, which required only time for a 
favourable issue. I believe, however, that this source of evil is 
daily diminishing, under the brighter light which multiplied obser- 
vation is pouring upon the field of pathological medicine. The 
age of heroic doses, like that of heroic deeds, is retreating before 
the march of sound reason and common sense. It is chiefly in the 
outskirts of the profession that the attempt is now made to take 
disease by storm. The number is comparatively few, who would 
choose to beat down defences by a shattering cannonade of calo- 
mel, which are ready to surrender on demand, or to yield uninjured 
to a gentle siege of starvation. Against the risk of a too frequent 
or too abundant recourse to medicines, there is no better safeguard 
than a diligent study of pathology in its present improved and im- 



ABUSES OF THE MATERIA MEDICA. 127 

proving condition ; and this study, therefore, I urge upon you, with 
the caution, however, that you guard against its seductions, and 
remember that, though it is highly desirable to understand the 
nature of disease, it is still more so to be able to cure it. 

A disposition to employ medicines too profusely may sometimes 
have its origin in another source. Over a large portion of our 
country, the physician supplies his patients with medicine as well 
as advice, and receives compensation for both. It thus becomes 
his interest, in a pecuniary point of view, to leave no opportunity 
for the insertion of a dose unimproved; and, though the great 
majority of practitioners are of a grade of morals above such an 
influence, it is yet not altogether unfelt, and probably, in many 
instances, operates insensibly in giving a bias to the judgment. In 
England, where much of the medical practice is in the hands of the 
apothecaries, who until recently were allowed to charge only for 
medicines, and could demand no compensation for advice, the in- 
fluence of this principle of self-interest over the consumption of 
drugs has been enormous. Imagine a case of disease, such as fre- 
quently occurs, requiring only a watchful guard against injurious 
influences; represent to yourselves the practitioner making his 
daily visit, and each time retiring with the consciousness that his 
services must remain unrequited, unless he can find occasion for the 
employment of medicine ; is it in human nature to resist the tend- 
ency of such a position ? Even where conscience is firm, will not 
the judgment almost inevitably yield to the constant solicitation of 
interest ? Will not the almost certain result be the discovery of 
latent indications for some pill or potion, which, by going down 
the throat of the patient, may allow a fee to enter the pocket of 
his attendant ? I have understood that it was formerly no uncom- 
mon practice with the apothecary in England, when occasion was 
supposed to exist for some mild medicine, such, for example, as a 
dose of salts, to send it in half a dozen potions, to be taken at inter- 
vals, at the cost to the patient of one or two shillings for each dose. 



128 ABUSES OF THE MATERIA MEDICA. 

The system which led to such abuses was in the highest degree 
absurd, and has been so far modified as to allow the apothecary to 
make a charge for his advice; but the customs of prescribing to 
which it gave rise are still in existence ; and the English continue 
to deserve the credit, which they have long enjoyed beyond all 
other nations of Europe, of being a drug-consuming people, In 
consequence of this tendency to abuse, as well as for other very 
important reasons, it is highly desirable that the prescribing and 
dispensing of medicines should be in different hands. In Phila- 
delphia and some other of our larger towns, the separation has 
already been effected ; and a movement towards the same result is 
observable in most parts of our country, where the population is so 
distributed as to admit of it. I would strongly press on you the 
propriety of contributing your own efforts in forwarding this move- 
ment, when you shall have entered that practical career, to which 
most of you are now looking forward. 

If the physician, in early life, is in danger of overvaluing medi- 
cines, and consequently of prescribing them too profusely, he is no 
less in danger, as he grows older in practice, of restricting the 
number employed within too narrow limits. Disease often runs 
for a long time in particular channels, and requires particular 
courses of treatment. Medicines not calculated to answer the 
indications most frequently presented, are apt to escape the recol- 
lection of the practitioner, or leave but faint and ineffectual traces 
in his memory. He finds it irksome to maintain, by constant study, 
a knowledge which is but of occasional application. The heavy 
armour with which he was loaded in the outset becomes fatiguing 
in the progress of his march, and, finding portions of it of no use 
upon ordinary occasions, he indolently throws them away, and thus 
leaves himself destitute of the requisite means of offence against 
disease, presenting itself in new and unexpected forms. He ac- 
quires a routine habit of prescribing certain medicines, which thus 
assume an undue prominence in his estimation, and present them- 



ABUSES OF THE MATERIA MEDICA. 129 

selves on every occasion of emergency, to the exclusion of others 
better adapted to the novel circumstances. A similar result fre- 
quently grows out of an indolent mental habit, which shuns on 
every occasion all labour of thought that is not absolutely essen- 
tial. To consult, in the choice of medicines, the caprices of the 
palate or stomach, the prejudices of opinion, and the various con- 
trarieties of a nervous or irritable temperament, though not unfre- 
quently of great importance to the successful treatment of disease, 
requires an effort of memory and judgment which is too often 
avoided by practitioners, not conscientiously alive to all the duties 
of their station. Numerous remedial substances, which may be 
considered as light troops to be employed in our skirmishes with 
disease, or as a reserve against sudden emergencies and peculiar 
danger, are thus entirely neglected, and become useless in the con- 
flict. You will agree with me in the opinion, that he who wishes 
to qualify himself best for the practical duties of our profession, 
should sedulously guard against these sources of error. For this 
purpose, he should not only as a student form an intimate ac- 
quaintance with the materia medica, but afterwards, on entering 
into practice, should resolutely determine to maintain and improve 
this acquaintance by a frequent reference to works upon the sub- 
ject, even when no immediate call may exist for the practical appli- 
cation of the knowledge thus acquired. 

The influence of fashion and that of novelty are often felt in the 
use of medicines. A new remedy, or some new modification or 
application, or the simple revival of one before known, comes acci- 
dentally to the notice, or suggests itself to the researches of an 
ardent practitioner, who is willing to believe what he hopes, and, 
in his experimental investigations, can see nothing but confirmation 
of his belief. The world soon receives the benefit of his observa- 
tions, which a sense of duty may have brought forth, but which 
lose none of their attractiveness in passing through the nursing 
hands of self-interest and love of distinction. The journals glow 



130 ABUSES OF THE MATERIA MEDICA. 

with the rapture of a new discovery. Excitable imaginations 
catch the sparks which scintillate from their pages, and kindle 
into enthusiasm. The flame spreads rapidly, till at length even 
sluggish natures are warmed into action ; and the whole profes- 
sion turns from its accustomed course to luxuriate in the new hopes 
which are opened before it. The medicine thus brought into vogue 
receives the stamp of fashion, which continues to give it general 
currency, till some other novelty is struck off, and by its bright 
freshness puts to shame the tarnished and worn-out attractions of 
its predecessor. Thus, in the practice of our profession, as in 
everything else connected with the feelings and thoughts of men, 
one wave incessantly follows another; and the general welfare, 
instead of advancing smoothly upon an unruffled tide, is tossed 
about and retarded, and sometimes almost wrecked in the surges 
of unstable opinion. It becomes every practitioner to contribute 
all in his power towards a more equal and consistent progress. 
He should strengthen himself, by the influence of judgment and 
discretion, against the paroxysms of excitement to which we are all 
more or less exposed. Without absolutely rejecting every novelty 
which may float along the current of events, he should be careful 
not to endanger his balance by reaching out too far to seize it, 
and should never allow himself to be carried aw T ay by the flood of 
fashion from any well-established and advantageous position. In 
this spirit, he should coolly examine the claims of alleged discov- 
eries, trusting nothing to partial testimony, which in medicine is 
excessively deceptive, and, having sifted out the truth by careful 
trial, should give it an appropriate place in his storehouse of 
practical knowledge, without allowing it to disturb unnecessarily 
the general arrangement, or to displace any important fact or prin- 
ciple. 

More injurious than either of the preceding sources of mischief, 
is the influence of false theory upon the employment of medicines. 
Almost from her birth, materia medica has been the sport of hypo- 



ABUSES OF THE MATERIA MEDICA. 131 

thesis. Tossed about from one medical creed to another, and 
sometimes almost torn asunder by the struggles of opposing par- 
ties, she has survived to the present time, to be still exposed to 
bufferings on the one hand, and injudicious fondling on the other, 
from which all the efforts of sound judgment and common sense 
are requisite to save her unhurt. You may receive it as an indis- 
putable truth, that any claim to your guidance in the use of medi- 
cines, founded upon an hypothesis assuming to be of universal or 
even general application, is wholly groundless and futile. The 
facts of our science are yet far too limited to enable us to form a 
general theory of medicine upon the only true foundation, that of 
strict induction. How is it possible for us to draw from our know- 
ledge of the human system a doctrine explanatory of all its morbid 
actions, when we are almost wholly in the dark as to the nervous 
functions, and of the principle of life itself know scarcely more than 
its existence ? We might as well attempt to form an accurate 
map of a country from our knowledge of a few of its prominent 
points, while ignorant alike of its boundaries and its interior. 
Yet so presumptuous is man, that he frequently undertakes the 
impossible task. With intellectual powers, which, in comparison 
with the object, are infinitely feeble, he strives to penetrate the 
secret counsels of Almighty wisdom. Like the giants of old, he 
heaps up his mountain upon mountain, and with audacious vanity 
hopes to seize upon heaven itself by violence. There is only one 
path to truth in science, and that is the straight but narrow and 
laborious path of observation and experience. It is true that false 
theories, if without practical bearing, may sometimes be useful as 
aids to the memory; but, when they have relation to human life 
and happiness, they become engines of incalculable mischief. Sys- 
tems of medicine, therefore, claiming to be universal in their scope, 
as they are necessarily false, must be of the most injurious practi- 
cal influence, and, though often attractive to the inexperienced by 
their apparent beauty and labour-saving promises, should be dis- 



132 ABUSES OF THE MATERIA MEDICA. 

carded as sweetened poisons poured into the very fountain of life. 
It is a most grateful reflection, that the present tendency of the 
enlightened part of the profession is in an opposite direction. 
Medical men have at length begun to enter the Baconian path. 
It is now becoming the fashion to observe accurately and exten- 
sively, to collect facts abundantly, to sift these facts by a most 
rigid scrutiny, to compare them with the greatest care, and to 
draw no inference which is not so hedged round by various de- 
fences as to be almost unassailable. Though this system has had 
numerous advocates, no one has done more towards rendering it 
popular, and bringing it into extensive practical operation, than 
M. Louis, of Paris, whose works are models of scientific explora- 
tion applied to medicine, and whose pupils, both in France and 
this country, inspired by a zeal little inferior to his own, are 
labouring successfully in the same great cause. At present, there- 
fore, we have, as a profession, less to fear from false theory than 
at any former period. 

It is true that the homceopathists, or disciples of Hahnemann, 
are said to be making considerable impression on the community, 
and some practitioners of that school are supposed to be reaping 
largely the fruits of public credulity ; but the profession itself has 
not become contaminated, and none but a few of peculiarly ex- 
citable imaginations are ever likely to yield up their judgments to 
its monstrous absurdities. I feel that it is wholly unnecessary for 
me to guard you against a doctrine which prescribes, for the cure 
of each particular disease, the medicine most closely imitative of 
the disease in its effects upon the system, and recognizes the 
greatest curative efficiency in doses, no matter of what medicine, 
varying from the millionth to the decillionth of a grain. Luckily 
for the dupes of this imposture, the enormity of the first branch of 
the hypothesis is neutralized by the almost inconceivable folly of 
the second. Thus, upon the homoeopathic doctrine, you ought to 
cure apoplexy by a blow upon the head ; but the blow must be of 



ABUSES OP THE MATERIA MEDIC A. 133 

no greater force than the millionth part of the weight of a feather : 
in other words, you do not kill your patient, because the means 
you employ are wholly inert. The fact is, that homoeopathy is 
nothing more than a childish hallucination, which shakes its little 
fist at the giant of disease, and attributes the overthrow occasioned 
by the mighty hand of nature to its own Lilliputian blows. But, 
though it does little positive harm, it is the indirect cause of much 
evil by preventing positive good. It is desirable, therefore, that 
the community should be protected against its impositions ; and it 
becomes the duty of the physician, to do what lies in his power to 
disabuse those who may have been captivated by its pretensions. 

The only hold of homoeopathy upon public favour is its appa- 
rent success. You may uncover its absurdities to the understand- 
ing, and most persons of good sense will join with you in condemn- 
ing it; but others will answer that they do not pretend to be 
capable of estimating medical theories, that they judge by the re- 
sult, and that, in relation to the system in question, this is often 
favourable. Patients treated by the homceopathists get well; and 
sometimes they are asserted to have got well after the usual medi- 
cal treatment had been fruitlessly exhausted. This is the strong- 
hold of all irregular practice ; and, unless you can conquer it, 
argument and ridicule will equally fail to produce an impression 
on the minds of many, whose imagination and capacity of belief 
are stronger than their judgment. Indeed, the minds of some 
persons are so constituted as to find attractions in moral extrava- 
gance and absurdity ; and, if they have the least apparent basis of 
fact to stand upon, will exhibit a faith equal to any possible emer- 
gency. In the absence, however, of even this slight footing, 
nothing short of insanity could withstand the assault of reason and 
ridicule combined; and homoeopathy must fall into immediate dis- 
grace, if its claims to great practical success can be upset. 

It would be folly to deny that patients recover in the hands of 
the homceopathists ; and I believe that a much larger proportion 



134 ABUSES OF THE MATERIA MEDICA. 

recover than under the treatment of irregular practitioners in gene- 
ral. Nay, I will go further and admit, that a disciple of Hahne- 
mann may be more successful than a very ignorant and unskilful 
physician, even though the latter may take rank in the regular 
corps. But what is the real cause of this apparent success ? I 
have too good an opinion of your common sense to suppose, that 
you can for a moment be disposed to ascribe it to the infinitesimal 
doses administered to the patient. Can any one of you possibly 
believe, that the decillionth of a grain of any medicine kept in the 
shops, a portion far too minute to be visible to the naked eye, and 
which the most powerfully magnifying microscope would be insuffi- 
cient to detect, is capable of producing the slightest impression on 
the system ? The truth is, that the success of the homoeopathists 
is almost exclusively negative. If their doses are too feeble to do 
good, they are equally incapable of doing harm ; and the patient 
gets well in the natural progress of the complaint. The tendencies 
of the great majority of diseases are towards health ; and, if no 
disturbing cause be allowed to interfere, they will sooner or later 
terminate in recovery. This fact cannot be too strongly impressed 
upon medical men, nor upon the community at large. It is a 
common notion, that every complaint which ends favourably is 
cured by the means employed in its treatment. Physicians them- 
selves often act as if they were under this impression, and, even 
when they know better, do not always take due pains to enlighten 
their patients on the subject. They are willing to reap the advan- 
tages of the credit ascribed to them, without duly considering that, 
by their acquiescence, they are playing into the hands of irregular 
practitioners. If every case which gets well under the care of a 
physician is a cure, so is every case which terminates similarly in 
the management of a homceopathist or a Thompsonian. Thus 
must the public reason ; and, as great efforts are made by every 
irregular aspirant to their favour to parade these cures before 
them, it is not at all surprising that they are frequently deceived, 



ABUSES OF THE MATERIA MEDICA. 135 

and yield their support where it is not deserved. Let people be 
taught the simple truth in relation to the natural progress of most 
diseases ; let the physician always be satisfied with the amount of 
credit really due to him, and take care that nature is not defrauded 
of hers ; and it is scarcely doubtful that the common sense of the 
community will be able to estimate irregular pretensions at their 
real value. They, like ourselves, will see in the supposed cures of 
the homoeopathist the real triumphs of nature, and in those of the 
more venturesome empiric, either the lucky blunders of ignorance, 
or the successful struggles of a good constitution alike against the 
disease and the medicine. Nor need we apprehend that they will 
not duly appreciate our own services. Though nature may cure 
most attacks of disease, yet there are many which are beyond her 
unassisted powers ; and there are still more in which her efforts 
may be materially aided, and the amount of suffering to the 
patient vastly diminished by judicious medical interference. Let 
us rid ourselves of all false pretensions ; let it be seen that we 
stand on the firm foundation of common sense, that our time and 
efforts have been directed to the search of truth, and that, having 
no interest distinct from that of the community, we can have no 
object in deceiving them ; and there can be no doubt that we shall 
be consulted in disease, whenever there is pain to be relieved, or 
supposed danger to be averted. 

But the apparent success of the homoeopathists is not ascrib- 
able, in all cases, to the natural progress of disease towards health. 
Much may also be attributed to the influence of new and strange 
processes upon the mind of the patient. In all purely nervous 
complaints, and in many others of a more complicated nature, the 
production of some profound impression on the feeliugs or imagi- 
nation will often occasion a temporary, if not a perfect cure. 
There is no difficulty in understanding this fact. The brain, which 
is the centre of all sensation, is also the seat of the intellect and 
passions. When the latter are excited into powerful action, the 



136 ABUSES OF THE MATERIA MEDIC A. 

brain is necessarily affected ; and we can easily conceive that it 
may be rendered incapable, by the new condition in which it is 
placed, of perceiving those derangements which before occasioned 
pain, or gave rise to some irregular action. They who have suf- 
fered with toothache well know how often the pain entirely van- 
ishes, under the immediate expectation of the interference of the 
dentist. When the complaint is a mere functional derangement, a 
permanent cure may often be effected by a repetition of impres- 
sions, producing a continued revulsion to the brain. Now, with 
the homceopathists, as with others of the same group of practi- 
tioners, it is customary to employ measures calculated to make a 
strong impression on patients of an excitable temperament. Their 
close examination into the condition of every function and every 
organ ; their numerous inquiries as to the past history, sentiments, 
passions, and habits of the patient ; the commission, in many in- 
stances, of all the information thus derived to paper, in order that 
it may be scrupulously examined ; and then the solemn earnest- 
ness with which they advise the very careful smelling of an empty 
bottle, or prescribe one of their almost preternaturally small doses ; 
all this excites and occupies the attention, calls the passions and 
imagination into play, and involves the mind in a kind of wonder- 
ing awe, admirably calculated to revolutionize the condition of the 
nervous system. That real cures are sometimes thus effected, and 
temporary alleviations still more frequently, cannot be doubted ; 
but means of a similar tendency have produced the same results in 
all times and countries ; and homoeopathy, in this respect, may 
rank with the touch of a dead man's hand, the pow-wowing of the 
Indian doctor, and the more refined charlatanry of animal mag- 
netism. 

Still another cause of the occasional triumphs of the homceo- 
pathist is the remaining influence of previous regular treatment. 
The remedies employed before the commencement of his attend- 
ance sometimes continue their favourable operation, or begin to 



ABUSES OF THE MATERIA MEDICA. 137 

operate, after the patient has fallen into his hands ; and the credit 
thus accrues to him which belongs properly to another. An in- 
stance has been related to me, in which a patient with amenor- 
rhcea, who had been for some time under regular treatment, with- 
out apparent advantage, resorted to the advice of a homceopathist, 
and in less than twenty-four hours was gratified by a restoration 
of the suspended function ; but the credit which the new attendant 
might have derived from this accident was prevented by an unfor- 
tunate declaration which he had made, on his first visit, that no 
good could be expected until the remedies of his predecessor 
should have been removed from the system, and that for two weeks 
at least his efforts would be directed to that end exclusively. 

Upon all these points it is important that the public should be 
enlightened. Let them understand the true ground of those 
successes which are so diligently paraded before them, and their 
minds, extricated from the web of false inference in which they 
had been entangled, will judge correctly of the relative value 
of pretensions to their approval and support. They will recog- 
nize, in the elaborate preliminary examination of the homoeo- 
pathic physician, the mountain in labour, and in his infinitesimal 
doses, the ridiculous mouse. The whole system, which, viewed 
through the distorting medium of false assertion, seemed to be a 
real though mysterious and wonderful fabric, will to their unper- 
verted vision appear what it actually is, the phantasm of an ex- 
cited imagination, a mere intellectual illusion, better adapted to 
the sphere of a lunatic asylum than to the purposes of common 
life. 

The last and most prolific source of the abuse of medicines is 
the ignorance of those who undertake to employ them. Even 
within the limits of what is usually considered the regular profes- 
sion, there is unfortunately much presumptuous incompetence. 
The best informed physicians often have occasion to regret the 
inadequacy of their knowledge; how woful, then, must be the 



138 ABUSES OF THE MATERIA MEDIC A. 

blunders of those who enter into the practice of medicine almost 
without preparation, who have merely gone through the initiatory 
forms requisite for admission into our ranks, with as little previous 
expenditure as possible of time and study ! The number, however, 
of badly instructed, or wholly uninstructed physicians, in this coun- 
try, is an evil incident to its comparative youth, and is daily dimin- 
ishing with its increasing age. The establishment of medical 
schools, at various remote points, has tended to elevate the stand- 
ard of attainment, by bringing instruction within the reach of many 
who would otherwise have been content without it. The leaven 
of improvement has entered the profession, and will not cease to 
work till the whole mass is leavened. The time, I have little 
doubt, will come, when no one will undertake the practice of medi- 
cine without having availed himself of the advantages of the 
schools; and a degree will be as necessary a prerequisite in all 
parts of the country as it now is in our larger cities. The ques- 
tion will then be in medicine, as it must be in everything con- 
nected with humanity, not between skill and utter incompetency, 
but between different degrees of knowledge ; and the lowest grade 
will still be far above that of absolute ignorance. 

But it is in quackery that the source of abuse of which we are 
now speaking exhibits its most deleterious influence. This is an 
evil to which, in some one of its various forms, every nation, how- 
ever well guarded by laws, is in a greater or less degree exposed ; 
but in a country like ours, where liberty is almost riotous, and in- 
dividual will is constantly pressing upon the public good, it is 
scarcely possible to fix restraints upon a practice, which appeals so 
strongly to the hopes and fears of the ignorant multitude. As in 
our spiritual affairs, each claims the right of walking in his own 
path, his own interest only being concerned ; so, in the care of our 
bodily health, we are unwilling to relinquish a similar privilege, 
even though, in the opinion of those best informed, our course may 
lead to destruction. Hence empiricism broods almost undisturbed, 



ABUSES OF THE MATERIA MEDICA. 139 

and her venomous offspring swarm in every corner of the land. 
It is not my intention to describe the various forms of her evil 
progeny. Even were the object worthy of the labour, time is not 
allowed me to enter into the disgusting detail ; and I am entirely 
confident that not one of my auditors needs any warning, to keep 
his own skirts clear from the contamination. The relation which 
every high principled medical man must bear to quackery is that 
of uncompromising hostility ; and the considerations in regard to 
it which have the most interest for him are such as concern the 
defence of the public against its seductions. A few general obser- 
vations on this point, which, if time permitted, might be greatly 
extended, will close the present lecture. 

One of the most efficient means of successfully combating em- 
piricism, is to elevate the standard of attainment in the medical 
profession. Where this is low, it is not easy for the public to dis- 
tinguish between the pretensions of the regular, and those of the 
irregular practitioner. Quackery triumphs when she sees herself 
reflected in the practice of physicians. Let the student leave no 
opportunity unimproved of qualifying himself for the discharge of 
his future duties; let the practitioner, so far from being content 
with the attainments of his youth, cherish studious habits, and aim 
at constantly increasing knowledge and skill; let all who have at 
heart the honour of the profession, encourage those only to enter 
it who are suitably gifted with talent and industry, and urge upon 
these the importance of ample preparation; and we shall soon 
establish so strong a line of distinction between regular practice 
and empiricism, that the dullest eye will scarcely fail to recognize 
it, and the dullest intellect to perceive on which side of it will be 
the greatest security. 

But, above all other things, it is important that the physician 
should not in any way countenance quackery, or encourage it even 
in its least pretending forms. If, from facility of disposition, dis- 
trust of our own qualifications, interested views, or from any other 



140 ABUSES OF THE MATERIA MEDICA. 

cause, we afford the slightest opening for the insertion of its roots, 
it is sure to fix its parasitic growth upon us, and to flourish at our 
expense. Touch not, taste not, handle not — should be our motto 
in relation to this great evil. Is a secret remedy offered for our 
trial or approval — we should firmly decline the insulting offer, and 
let it be clearly understood that we recognize no secrets in medi- 
cine. Does a patient ask our permission for the use of some nos- 
trum whose character is unknown to us — we should resolutely 
resist the solicitation, and yield up the case altogether rather than 
retreat from our position. It is not the mischief which might re- 
sult, in any particular instance, that should influence us, so much 
as the danger of sanctioning a deleterious principle. Should we 
incautiously recognize the efficacy of some empirical remedy in a 
single case, our stamp will be immediately placed upon it ; and, in 
spite of subsequent remonstrances, it will be made to pass current 
for whatever value its unprincipled circulator may find his interest 
in attaching to it. Should one of these nostrums be employed 
under our observation, and the patient recover in spite of it, the 
cure will be ascribed to the medicine, and serve as the foundation 
of its less innocent use in other cases of supposed analogous char- 
acter. There is no end to the mischief which may thus grow out 
of an inconsiderate act, on the part of an influential physician. 
But, if prohibited from giving our sanction, in the remotest de- 
gree, to the empiricism of others, how careful should we be to keep 
our own hands clean ! To put forth a secret remedy ourselves, or 
to permit our name to be attached to such a remedy, is to afford 
the strongest possible support of example to the cause of quackery. 
There are other practices which, though not strictly empirical in 
themselves, have acquired a suspicious character from association, 
and should therefore be carefully eschewed by the physician. To 
bring our successes or supposed successes in every possible way 
before the public, to support our own doubtful statements by the 
auxiliary certificates of volunteer or recruited witnesses, to pro- 



ABUSES OF THE MATERIA MEDICA. 141 

claim our superiority over our fellow-practitioners in some branch 
of the healing art, to which we wish to have it believed that we 
have devoted particular attention ; these and other analogous 
modes of proceeding are so often put in practice by notorious 
quacks, that the physician who resorts to them cannot escape the 
imputation of countenancing these impostors, and must be content, 
while he aids their cause with the public, to take rank with them 
in the thoughts of his professional brethren. 

It is not by openly attacking empiricism before the public, that 
we can hope to overthrow it. Our arguments make little impres- 
sion, as they are supposed to proceed from interest ; and the sym- 
pathies of the multitude are drawn to the party assaulted, by the 
cry of persecution. The privilege of reply is, moreover, made 
available for the purpose of puffing ; the attention of the public is 
roused by the controversy; and great numbers become familiar 
with the wonders of the panacea, who might otherwise have never 
heard of its existence. Besides, in disputes of this kind, the party 
which has most self-respect is usually in the most disadvantageous 
position; as he feels under restraints in relation to the truth of 
assertion, and the proprieties of language, which are scorned by his 
opponents. The profession scarcely commits a greater error in 
originally yielding countenance to empirical pretensions, than in 
subsequently assaulting these pretensions through the public press. 
The flame which might have expired without the first favouring 
breath, is increased into a conflagration by the blast intended to 
extinguish it. All that we can do with advantage is to bring 
occasionally before the public the adverse incidents in which em- 
pirical practice is exceedingly fruitful, and, placing them in their 
true light, without attempt at false colouring or exaggeration, to 
leave them to their legitimate operation upon the common sense of 
the community. 

But the same caution is not necessary in our private communi- 
cations. Every physician has a certain circle within which he 



142 ABUSES OF THE MATERIA MEDICA. 

moves, and in which his professional opinions, duly expressed, can- 
not but have considerable weight. As circles of this kind make 
up, in the aggregate, almost the whole community, it follows that 
medical men, acting in unison, must have it in their power to pro- 
duce a strong impression upon public sentiment in relation to all 
the concerns of health. Let us reason in the following manner 
with our friends and patients. You will admit that in any common 
art, they only are to be trusted who have made this art the object 
of especial culture. You would not go to a painter for instruction 
in music, nor to a musician for your portrait. In what does the 
art of medicine, in this respect, differ from others ? Who are most 
to be trusted, they who have endeavoured to make themselves ac- 
quainted by laborious study with all that has been learned in rela- 
tion to disease and its treatment, or they whose only title to notice 
consists in their own assertions ? Is not some knowledge of the 
human system, in its healthy state, requisite for those who attempt 
to remedy its derangements ? and yet what empiric will you find 
impudent enough to claim an acquaintance with anatomy? If 
these men have the skill they profess to have, it must have come 
by inspiration. Are they usually such, in their lives and characters, 
as to render it probable that they would be selected as recipients 
of so high a favour? Empirical medicines are often proclaimed to 
be infallible, and especially in diseases commonly deemed incurable. 
How does it happen, that the stigma of incurability still adheres to 
these diseases, notwithstanding the facility of resort to the remedy 
afforded by the philanthropy of its discoverer ? The very essence 
of quackery is the ascription to particular medicines of a sovereign 
power over particular maladies. Now, no disease is the same under 
all circumstances. It differs in its degree of violence, in its stages, 
in the constitution of the patient, in its complication with other 
affections ; so that the medicine which may prove remedial at one 
time, may act as a poison at another ; and substances possessed of 
any power whatever can never be empirically employed without 



ABUSES OF THE MATERIA MEDICA. 143 

risk of mischief. Besides, admitting for a moment the applica- 
bility of a particular medicine to the same disease under all cir- 
cumstances, how is a correct decision to be obtained in relation to 
the disease itself? The most experienced physicians often find 
great difficulty in ascertaining the precise character of cases which 
come under their notice : will not a person wholly uninformed be 
almost sure to err, and thus to use the medicine even where it may 
not be intended ? The aid of the regular practitioner cannot be 
sought for in forming the diagnosis, while the treatment is con- 
fided to the empiric. He knows too well what is due to himself, 
to the profession, and to the patient, to countenance in any way 
such vile impositions. It is true that quack remedies do not 
always destroy the patient ; but should they therefore obtain the 
credit of the cure ? If I knock a sick man down with a club, and 
nature is still powerful enough to restore him, is the result ascrib- 
able to the blow ? The medicine may even accidentally do good. 
So will any drug on the shelves of the apothecary, if employed in 
all cases of disease. If every man who is unwell should take a dose 
of calomel, benefit would result in some instances ; but is that a 
sufficient reason for the indiscriminate use of calomel ? The cures, 
therefore, so abundantly paraded by the empiric, are false colours, 
stolen from nature or accident, and intended as lures to draw vic- 
tims within his reach. The mischief which he does is left to the 
discovery of others, and is often concealed by the grave. 

These considerations, and many others which will readily sug- 
gest themselves to the physician, may be urged upon the good 
sense of those with whom he is socially or professionally connected, 
and will not be thrown away. Under such a course of proceeding, 
systematically and generally pursued, quackery would soon find 
itself excluded from the respectable walks of life. To eradicate 
the evil entirely will never be in our power. Its affinity for igno- 
rance and folly is too strong to be overcome by any available force ; 



144 ABUSES OF THE MATERIA MEDICA. 

and until human nature is regenerated, ignorance and folly will not 
become extinct. 

I have thus endeavoured to conduct you through the round of 
abuses to which medicines are liable. There may be some which 
have escaped my attention, and much more might be said on many 
points which I have been compelled to touch upon but lightly. 
You have, however, heard enough to satisfy you of the importance 
of attending to the subject. My design has been to point out the 
means not only of properly regulating your own habits of prescrip- 
tion, but also of correcting, so far as the circumstances of the seve- 
ral cases will admit of correction, those numerous abuses on the 
part of irregular and empirical practitioners to which the public is 
exposed. In the Course which is about to commence, I shall have 
abundant opportunities of satisfying you, that medicines, properly 
employed, are of indispensable necessity to the best management 
of disease; and I apprehend, therefore, little danger, from the 
somewhat gloomy picture presented to you, of any permanently 
injurious impressions on your minds in relation to the value of the 
materia medica. 



LECTURE Y. 



DELIVERED NOVEMBER 8th, 1838. 



Mental Agency in the Treatment of Disease. 

I confess to you, gentlemen, that, often as I have stood before 
meetings like the present, I never address a newly assembled class 
unmoved. At the sight of so many familiar faces, seen after a 
long interval, and all beaming with kindly recognition, I cannot 
repress the gush of feeling that springs from the recollection of the 
past. But the future also has its share in the excitement of the 
moment. On the good-will and kindness — may I not say on the 
friendship, of those who have so often before listened to me from 
these seats, I rely with confidence ; but there are many here for the 
first time, who come with unbiased feelings and judgment, and 
look to the future solely for their sentiments in relation to those 
under whose instruction they have enlisted. To these I cannot but 
turn with some solicitude. I know that a strict discharge of offi- 
cial duty will command their respect ; for the young heart is just. 
But their respect is not all that I desire. I wish also to possess 
their friendship. Between teacher and pupil a closer bond is requi- 
site than that of mere duty or interest. I need not tell you how 
much better all work is done when the heart is in it. I need not 
tell you how much more lively and vigorous are the masculine 
faculties of the intellect, how much brisker is memory, attention, 

10 (145) 



140 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

judgment, reason, imagination, when cheered and inspirited by the 
lovely companionship of the affections. Let the teacher act under 
the cold dictates of duty alone ; he may detail facts correctly, may 
collect all the essential materials, arrange them in due order, and 
lay them clearly before the student; but how lifeless and unimpres- 
sive his manner ! how irksome alike to himself and his hearers the 
performance of his task ! But let the heart lend its impulses ; let 
the affections awaken in the breast of the speaker; let him be ani- 
mated by zeal for his subject, and a warm desire to please as well as 
instruct; and then, how the eye brightens, how the whole counte- 
nance is lighted up, what life and soul breathe in the before languid 
utterance I Words acquire new force when thus clothed in the tone 
and emphasis of feeling. Memory rouses up from her slumbers, 
and pours forth her stores of corroborative fact and incident. 
Imagination is stimulated to exertion, and gathers ornament and 
illustration from every field of nature. The contagion of enthu- 
siasm spreads from the speaker to those around him ; the attention 
of the audience becomes absorbed ; every word is understood and 
appreciated ; and a deep, accurate, and permanent impression is pro- 
duced, instead of those vague and fugitive shadows of truth, which 
are often the only traces left in the memory by an uninteresting lec- 
ture. But there is nothing which contributes so much to animate 
the zeal of the teacher as the confidence that he enjoys the kind 
consideration, the good-will, the affection of his pupils. You will 
not, therefore, think me unreasonable in asking for the favourable 
sentiments of those among you to whom I am yet unknown; in 
expressing my fervent wish that we may commence our labours 
as friends together, disposed to cheer and assist each other n our 
progress, and to yield an affectionate sympathy under all circum- 
stances. 

My business in this school is to teach materia medica and phar- 
macy. On an occasion like the present, great latitude is usually 
allowed to the lecturer in the choice of his subject ; but there seems 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 147 

to be a propriety in maintaining a degree of consistency with the 
general tenor of his lectures ; and it may be expected, therefore, 
that the remarks which I am about to make shall bear some rela- 
tion to the branches of medicine just alluded to. In the most ex- 
tensive application of the term materia medica, it may be said to 
embrace all the means, of whatever nature, employed in the cure 
of diseases. A course of lectures, however, which should attempt 
to exhaust the whole subject, in this ample sense, would occupy 
much more time than can be allotted to it in the arrangements of 
our school. The lecturer is necessarily confined, in the body of 
his course, to the consideration of medicines strictly so called ; and 
I always find that my limits are strongly pressed upon by the 
abundance of material even thus restricted. But, as some of the 
remedial means not included within these limits are highly import- 
ant, it becomes proper in the teacher to avail himself of every 
opportunity, out of the ordinary course of his duties, to enforce 
their claims, and, so far as lies in his power, to make them familiar 
to his pupils. It is in accordance with this conviction, that I pro- 
pose, in the present lecture, to occupy your attention with some 
remarks on mental agency in the treatment of disease. 

Of the existence of an immaterial principle distinct from the 
frame which it inhabits, I presume that few if any of you entertain 
a doubt. That mere brute matter, by any possible arrangement of 
its particles, should acquire the power of thinking and feeling, is a 
supposition so abhorrent to the common sense of mankind, that 
none but those who have become bewildered in the labyrinths of 
a false philosophy are likely to adopt or support it. The belief 
of a soul within us, like that of a divinity above us, is the spon- 
taneous result of the mental organization of our species, and, if it 
does not rank with our confidence in self-evident truths, is at least 
deduced from what we see and feel by a process of reasoning so 
short and simple as not to escape the feeblest intellect, and yet so 



148 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

strong as to resist, with the majority of minds, the most ingenious 
and forcible attacks of sophistry. 

How this immaterial principle is connected with the machinery 
which it keeps in motion, we know not, and, on this side of the 
grave, shall in all probability never know. That it is capable by 
an excessive, deficient, or deranged influence, of throwing the ma- 
chinery itself into disorder, might be inferred a priori, and is 
abundantly proved by experience. Accordingly, in every treatise 
on practical medicine, we find moral causes enumerated among 
those most fruitful in the production of disease. To instance only 
a few examples; what physician is ignorant that violent anger may 
give rise to apoplexy ? that sudden emotions, whether of joy or 
grief, may suspend for a time, if not altogether arrest, the motions 
of the heart? that continued mental excitement is a not unfrequent 
cause of inflammation of the brain ; and mental depression, of dys- 
pepsia, chronic hepatitis, and various other forms of visceral de- 
rangement? that, finally, in the delicate female, the sensitive nerves 
often respond in hysteria and convulsions to the rude touches of 
anxiety or vexation, while even the iron cords of man's constitution 
sometimes melt before the flames of love ? 

But from a fountain thus overflowing with evil, may we not also 
draw something that is good ? If mental influence is often found 
among the causes of disease, may it not also be sometimes used as 
an instrument of cure ? To think otherwise would be doing injus- 
tice to that kind order of Providence, which has instilled something 
that is sweet into every cup of evil, which has ever made those 
roses the most fragrant that are accompanied with thorns. There 
can be no doubt that a skilful physician may often very advanta- 
geously enlist the aid of the mind against the bodily ailments of 
his patients. 

To give a complete view of all those therapeutical means which 
might rank under the head of moral remedies, and an exact detail 
of the best modes of applying them, even were time allowed me, 



MENTAL AGENCY IN THE TREATMENT OP DISEASE. 149 

would greatly exceed any ability which I may possess ; for the 
nature of mental action is often so subtle as to defy scrutiny, and 
its varieties so infinitely numerous that no patience could record 
them; and yet, there is scarce one of these flitting movements 
which, if seized at the proper moment, may not be made avail- 
able in the cure of disease. The cultivated and observant physi- 
cian, who is ever on the watch for assistance, and has his mind 
turned as well to the moral as the physical agencies within his 
reach, will constantly find opportunity in his path ; and common 
sense will teach him how best to use it. All that I can at present 
do, is to endeavour to render you duly sensible of the importance 
of this kind of aid, and to bring before your notice a few facts and 
considerations, as points about which your own reflections may 
cluster. Every mind sends out its crowd of thoughts in all direc- 
tions; what it most needs is a spot in which the swarm may 
gather, and thence proceed to labour in the great task of collecting 
riches and sweets from the flowery world around them. 

The feelings, emotions, and passions are perhaps those parts of 
our mental constitution which are most available for remedial pur- 
poses. It should always be borne in mind by the physician, that 
of these some have an excitant and others a depressing influence, 
and, when brought into play therapeutically, must be made to bear 
upon opposite states or tendencies of the system. Thus, all the 
modifications of joy, hope, anger, and the feeling of the ludicrous, 
are more or less stimulant, and, in their various grades of intensity, 
produce every degree of excitement, from the gentle glow of self- 
complacence, up, through the fever of succeeding or successful 
enterprise, to the delirium of rapturous enjoyment, or the over- 
whelming tumult of fierce and sudden wrath. Grief and fear, on 
the contrary, in their almost infinitely diversified grades and forms, 
diminish the energies and depress the actions of the system, and 
are even capable, in their excess of despair and terror, of producing 
fatal prostration. 



150 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

These different effects, in their relation to disease, we sometimes 
see exemplified, on a large scale, in the extraordinary prevalence 
of health during the invigorating influence of national prosperity, 
and in the low typhoid epidemics which are so apt to march in the 
rear of national distress. The resistance which that condition of 
the system, resulting from a cheerful and confident state of mind, 
affords to the assault of prevalent maladies, and the contrary 
effects of a fearful and gloomily foreboding temper, are familiar 
to all who have lived through a season of pestilence. The terror, 
which goes forth before the deadly epidemic, prepares the way 
for its devastating march. Why does pestilence so often respect 
the physician, but that it quails, like the tiger, before a cool and 
undaunted eye ? 

There are certain passions of a complicated nature, which pro- 
duce different and even opposite effects on the system, according 
as one or the other of their phases is presented. Thus, we have 
love with its joys and its hopes on the one hand, its sorrows, fears, 
anxieties, and disappointments on the other; jealousy and re- 
venge, now pining with their griefs, and now intoxicated by their 
hateful anticipations or accomplished wishes ; ambition with its 
fiercely exciting triumphs, its prostrating failures, and its anxious, 
harassing uncertainties ; and so with numerous other modes of 
feeling, which, if not essentially complex, are necessarily associated 
with varying emotions, through which they variously affect the 
state of health. Their effects, however, may in general be resolved 
into those of excitement and depression, such as result from the 
simpler feelings of pure joy and grief. 

The wise physician will have regard to all these influences in the 
cure of disease. It is true that he cannot always command them 
at will. He cannot prescribe them as he would a dose of medi- 
cine, or the loss of blood. They are, for the most part, the crea- 
tures of opportunity, and he must be ready to seize them as they 
appear. Often do they fly up suddenly and unexpectedly before 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 151 

his steps ; and, like a good sportsman, he must be prepared to take 
them on the wing. 

Of the more violent forms of feeling, the chances of a beneficial 
application are comparatively rare. They cannot usually be long 
maintained ; and, in most diseases to which they would otherwise 
be applicable, whether of an elevated or feeble character, injury 
instead of benefit might result from their transitory stimulation or 
depression. There are, however, occasions in which we may ad- 
vantageously call in their aid. When the disease itself is of a 
quick onset and fugitive nature, the violent shock of passion will 
sometimes roll back its surges, and leave the patient safe. In in 
stances of high nervous excitement, threatening convulsions per- 
haps or mania, a strong impression of terror or of grief will some- 
times quell the agitated nerves, and compel them to peace. The 
paroxysms of hysteria may often be turned aside by preoccupying 
the mind with the fear of some approaching evil. The excitement 
of some strong emotion may also be advantageously resorted to, in 
certain cases of morbid apathy which bid defiance to medicines. 
In such cases, the physician may sometimes lay the foundation of 
lasting gratitude from the patient, by purposely rendering himself 
for a time the subject of his anger. 

But much more useful results can be obtained from the milder 
emotions, which are more at our command, may be applied with 
less hazard to the patient, and can be much longer sustained. The 
supporting and even remedial influence of a cheerful, confident, 
hopeful state of mind, in low and protracted diseases, must be 
familiar to every observer. Hence, in our profession, the import- 
ance of manner to success, not only in the attainment of business, 
but also in the discharge of duty. The medical practitioner who, 
considering his patient as a mere piece of deranged machinery, 
enters the sick room as he would a work-shop, and hammers away 
at the disease like a blacksmith or a carpenter; who, taking no 
account of mental influence, talks by the bedside as he would else- 



152 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

where, and blurts out views and anticipations without reference to 
the anxieties, the wishes, or fears of the invalid, must frequently 
find himself at fault in his calculations, must constantly witness 
injurious interferences in his plans which he cannot explain, and 
encounter results contrary to his hopes and predictions, and strongly 
adverse to his reputation. A cheerful mien, an affectionate deport- 
ment displaying and at the same time inspiring interest, a kind and 
studious attention as well to the wishes and even caprices of dis- 
ease as to its claims, a mild forbearance in cases of irritability, 
peevishness, or fretfulness, with a disposition rather to soothe into 
quietness than forcibly to repress these morbid nervous irregulari- 
ties; such are the means which the physician should apply, in order 
to produce and sustain in his patient that trusting, grateful, satis- 
fied state of mind, so powerfully auxiliary to a course of medical 
treatment. He should also, whenever he can do so conscientiously, 
bring in to his aid the cheering influence of hope, and, if suitably 
gifted by nature, may superadd the gentle excitement of humorous 
and entertaining conversation, kept within the bounds of discretion. 
He should, moreover, endeavour so to regulate the circumstances 
in which the patient may be placed, in the intervals of his visits, as 
to maintain steadily this pleasing current of thought and feeling. 
In chronic cases of disease, especially those in which the digestive 
organs are materially interested, the aid of such mental influence 
is peculiarly requisite. Hence in part it is, that a patient long 
confined to his chamber, or to the narrow walks of a crowded city, 
often throws off at once the load of disease, when permitted to 
breathe the free air of the country, to drink in the delicious yet 
calm enjoyments of rural beauty, and to allow his mind, released 
from the anxieties of business, or the turbulence of ambition, to 
wander at will wherever fancy may conduct it, and gather in joy, 
and admiration, and gratitude, and a host of other agreeable or 
profitable emotions from the rich abundance of nature. Rural 
sports, the easy and unrestrained intercourse and the quiet amuse- 



MENTAL AGENCY IN THE TREATMENT OE DISEASE. 153 

merits of our watering places, the various adventure and diversified 
scenes of travel, by the agreeable excitement which they sustain in 
the mind of the invalid, contribute scarcely less than exercise and 
pure air, and much more, I believe, than the vaunted virtues of the 
waters, to those striking cases of amendment or cure which result 
from a journey to the different mineral springs of our country, so 
much the resort of fashion, debility, and disease. 

In relation to the beneficial influence of hope, and the prostrating 
effects of anxiety and fear upon the health of patients, especially in 
chronic disorders, or in the declining stages of such as are acute, 
it often becomes a question for the conscience of the physician to 
determine, how far he may be justified in deceiving the patient, in 
cases of danger, as to his real condition, and thus turning off his 
mind from that preparation, which it becomes every one to make 
for the awful future that awaits him. There are not wanting indi- 
viduals who rank it among the duties of medical men, to assume 
the charge of the spiritual as well as bodily interests of their 
patients, and like faithful watchmen to warn them of the approach 
of danger. Such a course would, I honestly believe, frequently 
realize a danger which might otherwise exist only in apprehen- 
sion ; and the physician, who should thus step out of the path of 
his own peculiar duties, ought not to be held guiltless of the very 
serious results which might ensue. I have always deemed it my 
duty, when the symptoms of a disease have taken on an alarming 
character, to make the relatives or near friends of the patient aware 
of his real condition, in order that they may have an opportunity 
for taking such steps as they may deem proper ; but, even in such 
cases, when asked my opinion as to the propriety of informing the 
patient himself, I have had no hesitation in advising silence, when- 
ever it has appeared to me that the alarm and agitation, conse- 
quent upon a contrary course, might greatly increase the hazard 
of an unfavourable issue. If they who are so fearful lest an indi- 
vidual may go out of the world ignorant of his condition, and with 



154 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

all his unrepentecl sins upon him, would consider that, in severe 
and acute disease, the mind is seldom in such a state as to be capa- 
ble of the great work of reformation, and that, in attempting to do 
a very doubtful good, they incur the hazard of producing a fatal 
result, otherwise perhaps avoidable, and thus precipitating the pa- 
tient into the very danger which they were most anxious to shun, 
they would be more cautious of interfering themselves, and less 
urgent upon the physician to assume so tremendous a responsi- 
bility. When the disease is necessarily fatal, and no management 
of the hopes and fears of the patient can materially affect the issue, 
the case assumes an exclusively moral character, and the physician 
should never stand in the way of such a course of proceeding as 
may seem best to those most nearly interested, nor, from a weak 
fear of giving pain, withhold that knowledge to which they have 
an undoubted right. There are, moreover, occasional cases, in 
which the probability of injury to the patient may be so far over- 
balanced by the probability of good from his knowledge of his 
exact position, that the physician cannot properly become instru- 
mental in giving or encouraging a false impression ; and there are 
others, in which he may well hesitate as to the proper course : but, 
as a general rule, the plan of cheering and encouraging the patient, 
of turning his attention to the bright side of his prospect, of sooth- 
ing his anxieties and fears, and removing as far as possible every 
agitating reflection, is as much the duty of the medical attendant, 
in doubtful cases of illness, as to keep away every noxious physical 
agent, and to apply every suitable physical remedy. 

Our attention has hitherto been directed to those states of the 
mind in which it is usually considered passive, and under the in- 
fluence of which the corporeal functions are either stimulated or 
depressed. There is another mental condition, which, as it is the 
result of causes usually not under the direction of the will, may 
also be considered passive, and which, though neither essentially 
stimulating nor depressing, exerts, however, a powerful influence 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 155 

for good or ill over the health ; I allude to the feeling of belief or 
faith, which you will all recognize as one of the most energetic 
principles of human action. That the simple existence of a firm 
belief is sufficient to bring about, in many instances, the event or 
condition of things believed, is among the best established truths 
in the history of the mind. Most of you must have heard of the 
familiar fact, that our native Indians, under the fatal prophecies of 
their priests or sorcerers, sometimes pine away and die; and 
dreams and visions foreboding misfortune or death have realized 
themselves through the credulity of their subject. It is true that 
belief operates, in general, not by an immediate influence on the 
system, but through the instrumentality of other principles which 
it brings into action. Thus, when the object of belief is of a pleas- 
ing or fearful nature, joy in the one case, and terror in the other, 
become the immediate agents of the result ; and in both cases, as 
well as where the object is quite indifferent, the imagination is 
often called powerfully into play; and awe, wonder, the vague 
feeling of the mysterious, and various other emotions lend an effec- 
tive aid. Still, faith is at the foundation of the whole ; and it is 
to this principle that the physician is to direct his efforts. Hence 
the importance of inspiring our patients with confidence in our 
skill, and wish to serve them. Thus aided, our prognostications 
will often fulfil themselves, and our prescriptions will operate with 
a double force. Most medicines will produce their peculiar effects 
with greater certainty, if the patient be previously made acquainted 
with these effects ; and it sometimes happens that, through the 
agency of faith alone, the operation of medicines may be imitated, 
even though not a particle may have been swallowed. It is thus 
that we may explain many of the phenomena which attend the 
homoeopathic practice. I have heard of profuse salivation induced 
by a dose of mercury, so small as to be invisible to the naked eye. 
Mercury has been sometimes called the Samson of the materia 
medica ; but I have no doubt that faith was in this instance much 



156 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

the stronger of the two. An anecdote was not long since related 
in my presence, somewhat illustrative of the principle under dis- 
cussion. A nervous female, having been attended for a consider- 
able time, with less benefit than she expected, by a young physi- 
cian, became at length impatient, and proposed to her attendant 
that he should give place to a homoeopathic practitioner. The 
physician acknowledged the inefficacy of the means hitherto em- 
ployed, but spoke of a new remedy which had been sometimes 
attended with very beneficial results, and advised a trial of it in the 
present instance. It was to be introduced into a glass bottle, and 
the patient was to smell of it very cautiously a given number of 
times for nine successive days, taking care to observe, with rigid 
accuracy, various directions of a trivial nature which were given at 
the same time. On certain days it was to produce certain effects, 
among which, I recollect, was a diarrhoea; and on the ninth day 
the cure was to be accomplished. The patient seized on the idea 
with avidity; and the medicine was accordingly soon provided. 
I hardly need inform you that the bottle, though well stopped, 
contained in fact nothing but atmospheric air. The directions 
were strictly complied with ; and, at the expiration of nine days, 
the physician called to learn the result of his new practice. He 
was happy to be informed that his patient was quite well, that his 
medicine had operated charmingly, and that the effects had taken 
place in their due succession, exactly as he had foretold them, 
diarrhoea and all. On the influence of faith, therefore, gentlemen, 
I would advise you to calculate largely, and never to lose a fair 
opportunity of securing its co-operation, when you can do so with 
a due regard to the feelings and character of the patient, to truth, 
and to your own reputation. 

The intellectual faculties, with the single exception of the imagi- 
nation, as they less observably affect, in their exercise, the func- 
tions of the system, are less available remedially than the mental 
conditions already alluded to ; but the physician cannot safely leave 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 157 

them out of his estimate, either in weighing the causes of disease, 
or in considering the means of its cure. It is a well-known fact, 
that a too vigorous or protracted exertion of the intellect is at- 
tended with the danger, first, of over-exciting and inflaming the 
brain, and, secondly, of abstracting the due supply of nervous influ- 
ence from the digestive organs, and thus giving rise to dyspepsia 
and all its train of evils. When such effects come under the notice 
of the physician, or good reason exists to apprehend them, he will 
of course recommend a temporary relaxation, or total abstinence, 
according to the degree of the injury or danger. 

But there are also cases in which he may advantageously resort 
to the active faculties of the mind as positive aids. In many in- 
stances, the suspension of mental effort, after one has been long 
accustomed to it, leaves an individual languid, uneasy, restless. He 
feels the absence of a wonted excitement, takes no interest in the 
objects around him, becomes depressed in spirits and often a prey 
to hypochondriacal feelings and notions; and at last, under the 
influence partly of mental dejection, partly of those habits to which 
it is apt to lead, his bodily health gives way, and the physician is 
called in to correct the evil. Such is very commonly the case with 
men, who, having spent a great portion of their lives in a constant 
and laborious pursuit of fortune, of fame, or of both, and, having at 
length succeeded, determine to retire, and devote the remainder of 
their days to quiet enjoyment. The only effectual remedy, in such 
cases, is to bring the intellect again into action, either in the origi- 
nal pursuit, or, if that has lost its charms, in some other adapted 
to the tastes and talents of the individual. 

Of the intellectual faculties, the imagination is, beyond compari- 
son, that with which the physician is most concerned, which he can 
wield most effectively against disease. In saying this much, I do 
not by any means assent to that very common error of language, 
which ascribes to this faculty all the extraordinary pathological 
results which occur through mental agency. If an individual faints 



158 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

at some painful intelligence, or sinks into a wasting disease under 
the influence of misfortune, or goes distracted with joy, or falls into 
hysterical convulsions when vexed or irritated, it is assuredly not 
the imagination which is to blame ; nor does this principle deserve 
the credit of the cure, when a neuralgic pain ceases through the 
operation of a well-founded fear, or an intermittent is suspended, 
as it sometimes is, by the mere agency of a rational faith. By the 
imagination we mean that faculty of the mind which brings before 
it images of things past or absent, or without prototype in nature, 
throws simple ideas into every variety of association not sanctioned 
by reason and judgment, discovers analogies and relations between 
objects which have no actual connection, and gives at the same 
time the force of truth to its unreal fancies. Scarcely any bounds 
can be assigned to the influence of such a faculty for good or for 
evil. There is not an emotion of the human breast which it may 
not call into action ; for it may place before the mind the pictures 
of things calculated to impress it in any way in which it is impres- 
sible, and may then impart to these pictures all the characters of 
reality. It is capable, therefore, of producing on the health, indi- 
rectly, whatever effects can flow directly from other mental sources. 
It is the great instrument by which empiricism, at all times and in 
all places, among the savage and the civilized, has operated upon 
the credulity of mankind. 

The regular physician, however, is much more limited than the 
empiric in the use which he can make of this principle. Regard 
to his own reputation and to the credit of his calling, as well as to 
the general claims of truth, forbid fraudulent deception ; and the 
convenient cloak of ignorance is wanting, under which he could 
conscientiously spread false impressions, because himself deceived. 
But it naturally happens, that a patient imagines more virtue in a 
medicine, or more efficacy in a course of treatment, or more skill 
in his attendant than the reality would warrant ; and the physician 
would do wrong in depriving him of the advantages of this impres- 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 159 

sion, from an abstract regard for truth. He may, I think, often go 
further than this, and stimulate somewhat the patient's imagina- 
tion when it flags, without any compromise of the great interests 
of morality; and, in cases where nervous derangement has im- 
paired or destroyed the power of correct judgment, he may take 
the reins wholly into his own hands, and guide the thoughts and 
feelings of the invalid into whatever channels he may deem most 
conducive to good. 

In an account of the mental influences capable of remedial appli- 
cation, we should not omit the fact, that any strong impression on 
the mind, of whatever nature, will often suspend or entirely remove 
disease. This is particularly the case, when the complaint is purely 
nervous, or, if attended with inflammatory symptoms, is of that 
volatile character which prevents it from fixing firmly on any one 
part of the frame. Intermittent diseases are also peculiarly sub- 
missive to this mode of cure. The chain of concealed morbid 
action which, probably, in these cases, runs through the intermis- 
sion, is broken by any powerful impression on the system, whether 
made through the agency of the mind or otherwise ; and the 
paroxysm which hangs upon it consequently falls. Sudden sur- 
prise, intense wonder, a feeling of the mysterious and awful, any of 
the stronger passions called into quick and powerful exercise, high 
excitement of the imagination, a very close and absorbing applica- 
tion of the attention or reasoning powers; any one of these causes, 
and still more certainly a number of them combined, is capable of 
so impressing the brain and nervous system generally, as to dis- 
place disorders having their root in this system, by substituting a 
new and incompatible action. 

Instances are scarcely necessary to illustrate this truth. You 
have all read of the dumb, who, under the influence of some irre- 
sistible call for the exercise of their lost faculty, have suddenly 
been restored to speech. The gouty man has found the use of his 
inflamed feet, and the paralytic of his palsied limbs, when their aid 



160 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

has been necessary to remove their possessor from some immediate 
and fearful danger. Who has not seen hiccough vanish before a 
sudden access of terror or surprise ? Neuralgia has yielded a thou- 
sand times to the complicated emotions, attendant upon certain 
empirical and highly pretending processes of cure. A seventh son, 
who, as is well known, has a divinely derived power of healing, pre- 
scribes for an obstinate ague ; and the sense of the supernatural, 
which spreads through the mind of the patient, proves more than a 
match for the disease. A natural bonesetter stands by the bedside 
of a nervous female, long confined by a sprained and neuralgic 
ankle; he declares the existence of a dislocation, and performs 
some trifling manipulation about the part; the pain vanishes be- 
fore his mysterious touch; the patient rises at his bidding, and 
finds to her astonishment that she can walk. The wonderful cure 
goes forth to swell the fame of the inspired operator, and adds to 
his power over succeeding cases. An Indian doctor, redolent of 
whisky, regards with solemn stolidity some superstitious subject 
of the colic, and mutters his supernatural charms. The disorder 
passes from the weak bowels of the patient to his weaker brain; 
and a cure is effected. The homoeopathist visits some recent 
martyr to palpitation of the heart; he looks wisely, scrutinizes 
closely, questions minutely about all manner of things, and, having 
put the mind into a delirium of various agitation, prescribes the 
millionth of a millionth of a grain of some medicine which he 
deems appropriate, and departs. At his next visit he finds his 
patient well, and gives glory to Hahnemann. I might go on mul- 
tiplying instances indefinitely; for they are as numerous as the 
diversities of credulous ignorance and folly on the one hand, and 
of knavish cunning, superstitious self-conceit, and intellectual hal- 
lucination on the other. The physician, it is true, can seldom con- 
descend to these doubtful methods of cure ; and yet there may be 
occasions in which he may, with propriety, take advantage of the 
principle, and endeavour to control or subdue the disease by the 
excitement of some strong but short-lived mental disturbance. 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 161 

It remains only that we should inquire, whether there are not 
certain mental states or actions which may be employed remedially 
in reference to their secondary effects. At the present moment, 
nothing of the kind occurs to me, unless we may rank under this 
head those psychological phenomena which have recently attracted 
so much notice, as the result of the so-called animal magnetism. I 
am not among those who are disposed to throw unmitigated ridi- 
cule upon this much-agitated subject. In the supernatural aspect 
which has at various times been given to it by the ill-regulated 
imagination of some of its warmer votaries, it merits only silent 
contempt. When miracles are urged upon our belief, we may, 
with great propriety, decline listening even to offered proof, unless 
there be presented, at the same time, an end sufficiently important 
to justify their performance. We may rest assured that the great 
physical laws of nature are never violated, in order to give notoriety 
to a few hysterical females and their managers, or amusement to a 
few idle lookers-on. But, while we utterly refuse credence to all 
that is miraculous in animal magnetism, let us not go to the oppo- 
site extreme, and reject, without examination, all within the bounds 
of possibility that is asserted of its powers. That many indi- 
viduals, particularly those of excitable nerves, are thrown into a 
peculiar deranged condition of the system, under the influence of 
processes brought to bear upon them by the magnetizers, is a fact 
at present, I think, too well established to admit of reasonable 
denial. This deranged condition is usually spoken of as sleep ; 
but it differs from ordinary sleep in some important particulars, 
and approaches more nearly to that state of the nervous system, 
which has been known under the name of somnambulism. The 
hands are generally cool and moist, the face more or less flushed, 
and the pulse increased in frequency. The senses are variously 
affected ; but in general the susceptibility to painful impressions 
is greatly diminished ; while the hearing, sight, and touch, espe- 
cially the latter, are often unimpaired, and sometimes rendered even 

11 



1G2 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

more acute than in the waking state. I do not pretend to give a 
full description of this disordered condition, and have alluded to 
the few points just mentioned only in order to show that it is not 
identical with natural sleep. The question at present is, whether 
its phenomena are induced merely through the influence of the 
mind of the individual affected acting on his nervous system, or 
whether, as the advocates of animal magnetism considered as a 
distinct branch of science suppose, the effect results from the physi- 
cal agency of the nervous system of the operator upon that of the 
subject of the operation, as a magnet, or an excited electric, affects 
other bodies in its neighbourhood. The latter mode of action is 
certainly not without the limits of possibility, that is, involves no 
positive contradiction of established laws of nature ; and they who, 
in a philosophical spirit, investigate the subject with a view to the 
discovery of truth, so far from meriting ridicule or censure, are 
entitled to our respect, if not commendation. But, in the present 
state of the question, I am decidedly inclined to the opinion, that 
all the phenomena of animal magnetism are best explained upon 
the exclusive ground of the mental agency of the individual 
affected. My reasons for this opinion are chiefly, first, that it is 
unphilosophical to seek for a new power to explain phenomena, 
which are at all explicable upon well-known and established prin- 
ciples; and, secondly, that, taking all the well-ascertained facts 
into consideration, they accord better with what we already know 
of the influence of the mind over the corporeal actions, than with 
any hitherto discovered physical influence, or even with any which 
has been invented by the fruitful imagination of Mesmer and his 
followers. 

It is impossible for me, in the very few nmmtes which remain, 
to develop fully my ideas upon this subject. I will only, for a 
moment, call your attention to the circumstances under which the 
peculiar phenomena of animal magnetism are usually produced, 
and thereby afford you some slight ground for a judgment in rela- 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 163 

tion to the question at issue. The individuals susceptible of the 
influence are usually persons of weak or excitable nervous system, 
such as children or delicate females, whose cerebral functions may 
be thrown into disorder by slight causes, and whose minds are not 
strengthened by matured reason or judgment against strange, ex- 
travagant, or superstitious fancies. The operator is in general a 
man,' often of fine physical developments, and almost always of a 
decidedly superior cast, either mentally, bodily, or by station, to 
the person upon whom he operates. Conceive now a subject such 
as I have described, a hysterical woman, or a delicate little girl, 
for example, placed before an individual of the opposite sex, of a 
vigorous frame and expressive features, who regards her with a 
serious, fixed, and to her inexplicable air, as if looking into her 
most secret thoughts, and confident of a commanding power over 
her feeble spirit, placing his hand mysteriously upon her head or 
brow, putting his thumbs into a still more mysterious contact with 
hers, and making certain magical movements about her, as if to 
bring her system within the circle of some supernatural influence ; — 
what condition of things could be conceived more likely to put the 
nervous system into disorder, and to produce some of those strange 
phenomena of which such disorder is the fruitful root ? A highly 
excited curiosity, an almost fearful wonder, a feeling of awe as in 
the presence of some mysterious power, an imagination thrown 
into the wildest confusion, and yet repressed by the stronger 
emotions of the moment — these, with perhaps other vague and 
undefinable agitations, interrupt the regular functions of the brain ; 
and, by a wise provision of nature, the individual, by becoming 
insensible of her condition, and of the circumstances around her, is 
released from a disturbance which might otherwise, perhaps, result 
in unpleasant effects upon the health. There is certainly nothing 
more wonderful in this than in the fainting which so often super- 
venes upon any sudden and very important intelligence, or the 
hysterical convulsions resulting from any disagreeable excitement. 



164 MENTAL AGENCY IN THE TREATMENT OF DISEASE. 

The latter phenomena are more familiar, because their causes are 
more frequently brought into operation. The magnetic sleep, as 
it has been called, would not seem more strange, were the circum- 
stances that induce the peculiar complex state of mind in which it 
originates, of ordinary occurrence.* 

You perceive that, viewing animal magnetism as I do, it would 
not have been proper for me to omit noticing it in an account of 
mental agency in relation to therapeutics. There can be no doubt, 
that a condition of system of so decided a character as that which 
has been engaging our attention, and capable of being induced, in 
many instances, with great certainty and precision, may be occa- 
sionally resorted to with advantage in the treatment of disease. 
The fact is, I think, beyond question, that the sensibility to painful 
impressions is sometimes greatly diminished during this state, so 
that surgical operations may be performed without rousing the 
patient. Many of you have heard of Cloquet's famous case, in 
which a cancerous breast was amputated, without the conscious- 
ness of the patient operated upon ; and in many instances teeth 
have been extracted without apparent pain. The advantage thus 
afforded to surgery is obvious; as the very persons most easily 
brought into the condition of diminished sensibility to pain, are 
those in whom such a condition would be most desirable in antici- 
pation of an operation. Another beneficial application of this 
indirect mental agency is to the relief of morbid vigilance, and of 
various distressing nervous disturbances, in which it may possibly 

* I -would here refer to an essay, by the late John K. Mitchell, M.D., pro- 
fessor of the practice of medicine in the Jefferson College, of Philadelphia, 
giving the results of his investigations and experiments in reference to ani- 
mal magnetism, as containing much interesting information on this subject. 
The essay has been published since his death (Philadelphia, a.d. 1859) by 
his son, S. Weir Mitchell, M.D., with several other essays, constituting a 
valuable collection of the more important contributions of the author to 
general and medical science. 



MENTAL AGENCY IN THE TREATMENT OF DISEASE. 165 

produce at least temporary good. But we are yet in want of suffi- 
cient precision in our knowledge of the phenomena of animal 
magnetism, to enable us to employ them therapeutically with the 
requisite confidence. Truth is so mixed up with error in the 
reports upon the subject; an almost delirious wildness of imagina- 
tion, and a very discreditable charlatanry, have so much sophisti- 
cated the sober researches of philosophy, that it is utterly impos- 
sible, in the present state of the subject, to deduce any precise and 
satisfactory conclusions from the mass of materials presented to us. 
It may be, that precision is unattainable ; but at least the pursuit 
of it ought not to be deemed visionary or absurd ; and should any 
plain and satisfactory results flow from the researches of indi- 
viduals engaged in this pursuit, whatever may be the issue in rela- 
tion to practical good, they will merit and obtain the lasting 
applause of the scientific world. 

With these remarks I close a slight sketch of a very ample sub- 
ject. It was not originally my intention to occupy so much of 
your time ; but the few points which presented themselves at the 
first glance, and seemed scarcely susceptible of sufficient extension 
to fill even the small space of a single lecture, spread themselves 
out under examination; so that my only difficulty has been to 
repress them within due limits. Should I have transgressed as 
much on your patience as your time, I have reason to be gratified 
by a forbearance, which I sincerely hope will be continued to me 
throughout the arduous duties of the coming winter. In the dis- 
charge of these duties I engage to you the best of my abilities ; 
and I repeat, in conclusion, a wish expressed in the commencement 
of the lecture, and which is seldom absent from my thoughts, that 
we may go on harmoniously together, yielding mutual countenance 
and aid, and disposed to extend to each other a friendly partiality, 
when the claims of rigid justice may be silent. 



LECTURE VI. 



DELIVERED NOVEMBER 2nd, 1842. 



On the Choice of Medicines. 

We are assembled, gentlemen, to enter upon a course of arduous 
labour. Those of you to whom the occasion is quite new, scarcely 
stand in need of encouragement. The ardour of a commencing 
enterprise is glowing in your breast; and the prospect of diffi- 
culties but animates you, as it offers scope to energies which are 
panting for action. But there is almost always something dis- 
tasteful in renewed exertion, after a period of temporary rest. 
They, who have once or oftener struggled through the torrent of 
various labour that now crosses your path, may well be excused if 
they experience a slight shudder upon again approaching its brink. 
But it is only the first plunge which you have to dread. It is true 
that, if alarmed, like a child on his first attempt at bathing, you 
enter hesitatingly into the chilling wave, first introducing one foot 
and then the other, and cautiously increasing your depth as you 
advance step by step, you may become benumbed and disheartened 
before you have had the opportunity for exertion ; but leap at once 
into the midst of your duties, strike out energetically with all the 
vigour you possess, and the first shock will soon be followed by an 
agreeable glow of reaction ; the consciousness of faculties exer- 
cised, and useful ends fulfilled, will spread a grateful satisfaction 
(166) 



ON THE CHOICE OF MEDICINES. 16t 

throughout your mental frame ; and you will experimentally feel 
the truth, that, though man has been condemned to earn his bread 
by the sweat of his brow, yet a kind Providence has lightened the 
infliction, by inseparably attaching a feeling of pleasure to every 
act of profitable labour. I may, therefore, congratulate you, gen- 
tlemen, as well as cordially welcome you on this occasion. I need 
scarcely say, that it will be both my duty and pleasure to facilitate 
your labours, and increase their productiveness by all the means in 
my power. Even in the present address I shall keep this object in 
view, and, while introducing the general subject of my course to 
your notice, shall endeavour to give you certain views which may 
be of some practical utility. 

You are aware that my department in this school is that of 
materia medica, or the science which treats of medicines. The 
time allotted, in the arrangements of the school, to the course of 
lectures on this subject is so completely filled up by practical de- 
tails, that little or none is left for considerations of a general 
nature, for which, therefore, I am compelled to seek opportunity 
in my introductory addresses. Through these, accordingly, I have 
endeavoured to present to the notice, and press upon the adoption 
of the student, various facts, sentiments, and principles, having a 
more or less close relation to materia medica, and a more or less 
important bearing upon its successful application to practice ; yet 
not exactly suited to the body of the course. I have thus, in 
different lectures, given sketches of the general history of materia 
medica, and of its particular history in the United States ; observa- 
tions upon the relative importance of the science, and its claims 
on the attention of the student ; an account of the more frequent 
sources of error and abuse in its practical application ; and a dis- 
sertation upon the advantages of a therapeutical recourse to moral 
influences as auxiliary to the physical. In continuation of the same 
plan, I propose at present to offer to the class some considerations 
upon the proper choice of medicines. 



168 ON THE CHOICE OF MEDICINES. 

The fact which, perhaps, strikes most strongly the commencing 
student of materia rnedica, is the great number of substances which, 
either as crude medicines or pharmaceutical preparations, swell 
the catalogues of authors, and load the shelves of the apothecary. 
From the first experience of pain and sickness, mankind probably 
began to look around into nature for sources of relief, and to accu- 
mulate substances of real or supposed curative efficacy. The con- 
tinuance of the evil has ever since sustained the search ; and an 
almost uninterrupted stream of contributions has been and con- 
tinues to be poured into the mighty reservoir of therapeutics. In 
the earlier ages, substances deemed inefficacious, after a sufficient 
trial, were probably consigned to entire oblivion ; but those w T hich 
the physician now rejects or abandons are received and preserved 
in the records of the press, ready to meet the researches of some 
future explorer, and again to run a brief course of popularity, as 
newly discovered remedies. The love of distinction, the hope of 
profit, and the necessities of an over-crowded competition, are con- 
stantly co-operating with the laudable desire of doing good, to 
bring forth new medicines, or new modifications of old ones ; and 
invention is tortured, not more in the production of the novelty, 
than in the collection or creation of plausible evidence in its favour. 
Though happily but a few centuries distant from the commence- 
ment of this more rapid course of accumulation, we have already, 
as may be seen by consulting the index of the Pharmacopoeia Uni- 
versalis, a list of something like twenty thousand medicines and 
preparations, more or less different from each other, recognized by 
the collective modern standards. What is to be done, a few cen- 
turies hence, if this respectable list shall go on increasing in the 
same ratio, we must be content to leave, together with many other 
equally puzzling questions, to the decision of posterity, wiiom they 
especially concern. For us it is sufficient to bear our own burden, 
and to take care that its magnitude do not overwhelm us. It must 
be obvious to you that, after having thrown nineteen parts out of 



ON THE CHOICE OF MEDICINES. 169 

twenty of this enormous mass away as utterly useless, it will still 
be necessary to make a cautious selection out of the remainder, in 
order to bring it within a manageable compass. The young prac- 
titioner, who has yet had little experience of his own, will neces- 
sarily be guided, to a great extent, by the recommendation or prac- 
tice of his preceptors, or by the dicta of the medical author in 
whom he may happen most to confide ; but it is desirable that 
every one should, in some measure, be enabled to form a judgment 
of his own, and not surrender himself to an exclusive dependence, 
which may have a favourable or unfavourable issue, as accident 
may determine the character of the authority upon which the de- 
pendence is placed. Perhaps I may be able to supply a few hints, 
which may be of some service to the student, in the exercise of a 
suitable degree of independence in his choice of medicines. 

Most of you are probably aware that, in every country or com- 
munity in which the profession of medicine is properly regulated, 
there is a standard, in a greater or less degree authoritative, which 
determines the particular medicines to be used, and the modes of 
preparing them. Such a standard is denominated a pharmaco- 
poeia. The one recognized in the United States, was prepared 
under the authority of conventions, which have, at certain inter- 
vals, met at Washington, and may be considered as having repre- 
sented the medical interests of the whole country. Our pharma- 
copoeia professes to give a list of all the substances, whether in 
their crude or prepared state, which are necessary to the prac- 
titioner of medicine in this country. As this list was originally 
prepared, after a due comparison of sentiment, by eminent phy- 
sicians from various parts of the United States, and has since, on 
two occasions,* undergone a most careful revisal, in which refer- 
ence was had to prevalent medical and pharmaceutical opinion and 



* At the present date, December, 1859, three occasions; viz., ad. 1880, 
1840, and 1850. 



170 ON THE CHOICE OF MEDICINES. 

practice throughout the country, it is, to say the least of it, much 
more likely to afford a just rule for the guidance of the young prac- 
titioner, than the decisions of any single individual, however promi- 
nent. I would not wish absolutely to restrict you to the use of 
medicines recognized by our national standard. This would be to 
demand a subserviency, incompatible with that freedom of thought 
and action which is essential to any improvement of our thera- 
peutics, and even to the most efficient exercise of known methods 
of cure. But, as a general rule, you will be most safe in not going 
beyond the limits of the officinal catalogue, until a judgment, ma- 
tured by experience, shall enable you to estimate duly the character 
of newly asserted, or revived pretensions. You will assuredly find, 
in this catalogue, abundant materials wherewith to operate in your 
first practical attempts. Its copiousness, indeed, is much beyond 
the necessities of ordinary practice ; and you will by no means be 
exempt from the duty of a careful selection, even should your field 
of choice be strictly limited by its authority. 

It is advisable always to seek, in the medicines you select, an 
energy proportionate to the character of the disease ; and espe- 
cially to avoid the habit into which too many fall, of resorting to 
the most powerful on every occasion. There is a class of prac- 
titioners who seem to look upon diseases as the Stoics did upon 
sins, as all equally heinous. No sooner do they catch a glimpse 
of something suspicious in the distance, than they conclude at once 
that it is an enemy, and, without estimating his strength, prepare 
to crush him by the most energetic measures. In every low black 
schooner they discover a pirate, and direct their paixan guns indis- 
criminately against the ship-of-the-line and the cock-boat. Hap- 
pily, this disposition is less prevalent than formerly, and, in our 
parts, has in great measure left the regular profession to seek a 
refuge among empirics. In the West, however, we are led to sup- 
pose that it still prevails with many practitioners. In that section 
of our country, they are accustomed to everything on a grand 



ON THE CHOICE OF MEDICINES. lfl 

scale, from their magnificent streams and prairies, their gigantic 
trees and great men, intellectually as well as physically, to their 
drachm doses of calomel. Perhaps the diseases, as they assert, 
may partake of the same gigantic character, and require corre- 
sponding treatment. Let us hope that they will hereafter partici- 
pate in our experience, and, whether from a change in the char- 
acter of the disease, or in the estimate of its force, learn, as we 
have done, the sufficiency, in most cases, of milder measures.* I 
would not, however, be considered as advocating an inert treatment 
of disease. I am in favour neither of the ptisan practice of the 
older French physicians, nor of the mere moonshine of the homceo- 
pathists. All I mean is, that the character of the medicine and its 
dose should be regulated by the nature of the disease; that we 
should treat mild cases by lenient and persuasive measures, and 
launch our thunders only at the refractory and the violent. 

Another error, analogous to the preceding, is the habitual use of 
numerous medicines, without .a precise knowledge of their powers. 
This is one of the characteristics of a semi-barbarous state of medi- 
cal science ; of an age which has not yet risen out of empiricism. 
The physician expects to overcome disease by brute force. Out of 
his magazine of medicines, he hurls against it one after another, 
with little discrimination, until either the disease or the patient 
sinks. Or he mingles numerous and wholly discordant substances 
into one huge prescription, and throws it like a bomb into the hos- 
tile garrison, in the hope that the scattering missiles may together 
overwhelm the enemy, or that some one at least among them may 
do fatal execution. The latter was a favourite proceeding with 
the ancient physicians, was handed clown by them to the middle 

* I am happy to say that, in relation to the excessive use of calomel, a 
great change for the better has taken place among practitioners in the 
Western and South-western parts of our country; though, if I have been 
rightly informed, the same tendency to the magnificent still occasionally 
shows itself in the use of very large closes of sulphate of quinia. 



172 ON THE CHOICE OF MEDICINES. 

ages, and began to decline only with that brighter light which 
broke upon the profession in the last century. Some of the an- 
cient formulas which have been preserved are very curious, from 
the number and heterogeneous character of the ingredients, and 
the utter want of any rational principle of association between 
them. Yet such is the influence of authority and habit, that one 
of these mixtures, called the theriac of Andromachus, which has 
about seventy constituents, was retained by the London pharma- 
copoeia of 1746, and still holds a place in the French codex, with 
its agaric, and asphaltum, and Lemnian earth, and dried vipers, 
and its fifty other absurdities. I presume, however, that its reten- 
tion, in the recent revision of the French national standard, was 
rather a concession of the majority to the strong prejudices of the 
few, than the result of the general professional feeling. It is cer- 
tainly less in accordance with the present intellectual illumination 
of Europe and civilized America, than with the twilight condition 
of Eastern Asia, where the medical superstitions and absurdities of 
former ages flourish in a congenial soil. Dr. Parker, the medical 
missionary who has acquired so much deserved credit by his surgi- 
cal labours in China, and whom many of you may remember as an 
attendant upon our lectures last winter, informed me that he was 
once applied to, by a dignitary of the Chinese Empire, for a remedy 
which would counteract the effects of opium upon the system, and, 
upon replying that there was no such remedy, was asked if he 
could not mix together a great number of medicines, some one of 
which might perhaps have the desired effect ; the very idea, pro- 
bably, which led to that famous jumble of a multitude of incon- 
gruous substances, supposed to have been contrived as a counter- 
poison by king Mithridates, and hence called the mithridate. But 
this addiction to polypharmacy, though characteristic of a rude 
state of medicine, and certainly not the predominant fault of the 
profession at present, is nevertheless still found with some imper- 
fectly educated physicians, and with a few, who, from their peculiar 



ON THE CHOICE OP MEDICINES. 113 

position, have inherited the views and practices of former ages, 
without participating in the movements of the present. It is a 
fault, too, into which a young practitioner, not upon his guard, 
may readily fall, as it naturally arises from an undue confidence in 
medicines, derived from books, and not yet corrected by observa- 
tion. It may be avoided by establishing the rule, not to prescribe 
a medicine, without a definite idea of its powers and the effects ex- 
pected from it, and never to mingle substances in prescription, 
without having carefully considered their mutual relations, as well 
chemical as physiological, and found them compatible in both. In 
short, the practitioner should look to the state of system, and the 
therapeutical indications which it presents, and then search, in his 
catalogue of medicines, for that one, or that combination of them, 
which is best calculated to meet these indications. 

There is a fault opposite to that just mentioned, into which, I 
think, there is at present greater danger of falling; that is, too 
limited an employment of medicines, and too great a simplicity in 
prescription. It was formerly the custom to dress up medicine in 
magnificent robes, and to load her with all sorts of gewgaw orna- 
ments, calculated to meet a savage or semi-barbarous taste. The 
maxim of a higher refinement, that "beauty when unadorned is 
adorned the most," appears to have recently led, in certain schools, 
to the opposite extreme of an excessive simplicity, which leaves 
the science with scarcely a garment to cover its nakedness. The 
theory of the unity of disease, originating with the famous Brown, 
and since supported, with various modifications, by much greater 
names both in Europe and this country, a theory which, in every 
deviation from health, recognizes nothing but a simple difference 
in the grade of action, very naturally led its advocates to the adop- 
tion of an almost equal unity in therapeutics ; remedies being em- 
ployed only in reference to their power of increasing or diminishing 
the depressed or exalted actions. Thus Brown, who saw debility 
everywhere, considered himself sufficiently armed against disease 



114 ON THE CHOICE OF MEDICINES. 

when provided with the laudanum and brandy bottles ; and Brous- 
sais, who could see little besides over-excitement, found in the 
lancet, leeches, and demulcents, the chief therapeutical resources 
of our art. 

The temptation to this extreme simplicity in the view and treat- 
ment of disease is very great; as it saves much labour of thought 
and study, and almost relieves the memory from the burden usually 
imposed upon it. Unfortunately, what it most wants is truth ; and, 
though very pretty in theory, it has been found not to answer in 
practice ; at least, after a fair trial, it has been generally aban- 
doned, even where formerly in the highest vogue. The student 
will, therefore, do well to guard against its seductions. If induced 
by its plausible fallacies to neglect the acquisition of an ample 
knowledge of medicines, he will find, after engaging in practice, 
that he has yet that knowledge to acquire, and had merely post- 
poned his labour to a less convenient period. 

Even when provided with a sufficient knowledge of medicines, 
the practitioner is in some danger of falling into a parsimonious 
use of them. Indolence sometimes leads us into a mere routine 
habit of prescribing. We get into the way of using some particu- 
lar medicine or combination of medicines for each particular indi- 
cation, and finding them generally to answer our purposes, are apt 
not to be sufficiently careful to watch for modifications of the dis- 
ease, or of the constitution, habits, or tastes of the patient, requir- 
ing corresponding changes in the medicine or the formula. The 
remark is peculiarly applicable to the country practitioner, who, 
as he is generally under the necessity of preparing his own medi- 
cines, and often of carrying them about with him, perhaps on 
horseback, finds the tendencies to curtailment, arising from a rou- 
tine practice, powerfully seconded by his personal convenience. 

The fact is, that a physician can hardly be furnished with a too 
copious list of medicines, provided that there is some real differ- 
ence in their remedial properties, that they are all in a greater or 



ON THE CHOICE OF MEDICINES. 175 

less degree efficacious, and that their effects have been so well 
studied that he can rationally prescribe them to meet peculiar de- 
mands of disease. It is even desirable to be in possession of 
several, having a similar or identical therapeutical operation, but 
differing in sensible properties, so as to render them acceptable 
to different tastes, habits, or idiosyncrasies of the patient. The 
stomach will sometimes receive a medicine when acceptable to the 
palate, which it would reject if disagreeable or disgusting; and 
such are occasionally the squeamishness and whimsical changeful- 
ness of a nervous temperament in disease, that the practitioner is 
compelled to task his memory and exercise his ingenuity to the 
utmost, to find the means of answering the variable calls of the sys- 
tem. Under these circumstances, he is best off who is possessed 
of the greatest variety of material out of which to choose. 

From all that has been said, then, you will infer that while, on 
the one hand, I would avoid the untimely use of powerful medi- 
cines or of exaggerated doses, would reject everything not pos- 
sessed of certain well-ascertained powers or useful properties, and 
would above all things eschew the practice of heaping together 
discordant or ill understood materials in one empirical recipe, I 
would, on the other hand, strenuously advise the student to make 
himself acquainted with as many efficacious medicines, of diversified 
properties, as he has the opportunity to study, and the capacity to 
store away in his memory. 

In their choice of medicines, some persons are much influenced 
by a reverence for what is ancient. When the world was making 
less rapid advances than at present, and at a period in reviving 
civilization when it had obviously not yet regained the standard of 
Greece and Rome, this was a very natural and an almost universal 
feeling. But now that, in almost all respects, we are quite on a 
par with the ancients, and in many vastly in advance of their 
proudest attainments, the feeling is much less common, and, where 
it exists, may be considered as almost indicative of eccentricity of 



176 ON THE CHOICE OF MEDICINES. 

character. Yet, to a certain extent, it does exist, and individuals 
are still to be found whose estimate of value is based on remote- 
ness of origin. The rust of antiquity is in their eyes the philoso- 
pher's stone, which converts whatever it rests upon into gold. A 
scroll of parchment which, when written, would scarcely have pur- 
chased a dinner for its owner, acquires, by the compound interest 
of fifteen or eighteen centuries, a value exceeding that of a whole 
modern library. A piece of sculpture of some Athenian artist out- 
weighs a modern banking-house, with all the paper of the bank in 
the same scale. To be able to trace his origin up to some success- 
ful robber of the dark ages, enables an aristocratic fopling of the 
old continent to outshine a Webster or an Irving. In the same 
eyes, a paring from the toe-nail of Galen is worth the whole brains 
of any score of modern doctors. So, a medicine consecrated by 
the praises of one of the old fathers of our art, possesses an energy 
not less miraculous than that of the decillionth of a grain of sand, 
which has undergone the due number of shakes, according to the 
rules of Hahnemann. But, as I have before said, this folly is not 
common, and it is scarcely necessary to put you on your guard 
against it. The tendency of our age, and more especially of our 
country, and still more especially of the youth of our country, is 
exactly the reverse. We are much fonder now-a-days of the fresh 
rosy cheek and dimpled smiles of novelty, than of the stern brow 
and gray beard of antiquity. That is the syren which is constantly 
luring us from the path of truth and sound judgment, and against 
whose deceitful charms I would now" warn you. The subject is 
practically so important that it will bear, and, indeed, requires 
some amplification. 

There is a strong leaning in human nature towards what is new. 
This is peculiar to no age, country, or condition. The Philadel- 
phian who joins the eager throng around a newspaper extra, 
posted up before some publication office, may claim a prototype in 
the Athenian who sought similar information from those he en- 



ON THE CHOICE OF MEDICINES 117 

countered in the streets. The swarms of South Sea Islanders, 



who gathered around Captain Cook and his fellow-voyagers, were 
actuated by the same feeling as the crowd of Americans, who follow 
at the heels of a foreign lord, or greet with their huzzas a foreign 
writer of novels. But strong as is, and has been, and ever will be 
the love of novelty everywhere, it is a feeling which finds a pecu- 
liarly congenial soil in the American bosom. We are essentially 
a restless people. Placed in a new country, working our way 
onward by new paths, and governed by institutions which, if not 
entirely new, are greatly different from all that has preceded them, 
and withal, finding ourselves, upon a comparison with others, 
gaining upon them in the race of wealth and power, we have lost 
our respect for experience and authority, and for everything that 
bears upon it the stamp of the past, and are accustomed to look 
towards the hitherto unknown and the untried for the means of 
further advancement. Let a new scheme of physical improve- 
ment be proposed : we seize the idea with eagerness, and dash head- 
long on with it, taking the bit between our teeth, and utterly dis- 
regarding the guidance and the restraints of prudence. Fulton 
proved the practicability of navigation by steam ; and, in a few 
years, there was scarcely a stream or lake in the country which was 
not covered with steamboats. A few canals had been made in 
England and France, and were the admiration of the world. The 
novelty was transplanted to America ; and the astonished nations, 
who had deemed our country yet a wilderness, and its people 
savages, heard that their boasted works had sunk into insignifi- 
cance by the side of ours. Railroads and locomotives were started 
in England. A congenial chord was touched among us ; and 
scarcely had the countryman ceased to be startled from his work 
by the puffing monster, with his huge train behind him, when the 
whole country, from one end to the other, and through all its 
recesses, appeared to be whirling along in every direction, as if 
motion were its proper element, and dwelling-houses but places of 

12 



L78 ON THE CUOICE OF MEDICINES. 

temporary rest. Nor are such results confined to mere matters of 
physics. Let a novelty in philosophy, or science, or religion, or 
medicine be started, and, true or false, we swallow it with avidity, 
allow it, half digested, to enter the vital current, and then, by the 
force of our thousand hearts, send it circulating through every 
portion of the system, either to be thrown off by our healthy ener- 
gies, or to become incorporated in our very structure, and hence- 
forth to form, as the case may be, a wholesome or noxious part of 
the constitution. You cannot look around you for a moment with- 
out being made sensible of this fact. It would scarcely answer to 
cite many instances. But, without going further, I may point to 
the exaggerations of mesmerism and phrenology in philosophy 
and science, to Mormonism in religion, and to Thompsonism and 
homoeopathy in medicine ; not to speak of that tornado of pills 
and potions which is raging at this moment, with an almost unex- 
ampled fury, through the whole land. 

It must be clear to you that this restless love of what is new, 
while it is producing much good, is working also no inconsiderable 
amount of evil. It is true that we have canals and railroads in 
abundance, thus vastly facilitating our means of communication, 
and the interchange of visits and commodities. But have we not, 
as a set-off, loads of debt, which are pressing us to the earth, an 
exhausted credit, a reputation suffering abroad, and a universal 
stagnation or collapse of business, following the excessive excite- 
ment ? It is true, that we are reaping the intellectual and physi- 
cal advantages of a quick reception and rapid circulation of moral 
and scientific truth, wherever it may first come to light. But have 
we not also circulated the poison with the nutriment ? and are not 
our judgments weakened, our morals tainted, and our mental habits 
vitiated by familiarity with the outpourings of European folly and 
vice, not to speak of the corruption which is generated in our own 
moral body, and circulated with the rest ? It is true, that we 
have become familiar, in medicine, with the numerous and most 



ON THE CHOICE OF MEDICINES. It 9 

valuable truths which the last half century has developed; have 
learned to see the secret workings of disease within the recesses of 
the breast and heart, and have received the inestimable gifts of 
quinia, and morphia, and iodine. But have we not also received 
error along with truth ? Have we not felt the influence of false 
doctrine in every vein and fibre, and do we not still feel it counter- 
acting the wholesome workings of the efficient and the true ? And 
do we not behold every day patient after patient, dropping out of 
the hands of regular practitioners into those of mere pretenders ? 

It may be asked, are we therefore to reject all that is new? 
Are we in all instances to decline the good, lest we receive evil 
along with it ? Certainly not. But we should endeavour to con- 
trol this inordinate love, and eager search of mere novelty. In- 
stead of taking a thing to our bosom because it is new, we should 
receive it at first with suspicion, and should make its novelty a 
reason for a close and sifting examination of its character. When 
a stranger presents himself to us, do we receive him at once with 
open arms, introduce him into the midst of our families, give him 
access to our dearest treasures, and thus open, perhaps to fraud 
and villany, the path to their evil ends? Do we not rather ask 
for his credentials, and then afford him a fair opportunity for 
proving his worth, before bestowing upon him our whole confi- 
dence ? So should it be in our art. So should it be in our choice 
of medicines. 

At this very moment, in the rage for novelty, we are threatened 
with an innovation in chemistry, which promises to subvert some 
of the facts of the science previously thought to be among those 
best settled, and to work an almost complete revolution in its 
nomenclature. The salts are no longer to be compounds of acids 
and metallic oxides, but of certain complex radicals with the metals 
themselves. Glauber's salt has usually been thought to consist of 
sulphuric acid and soda. Henceforth, according to the new theory, 
we are to look upon it as a compound of sodium, and an imagi- 



180 ON THE CHOICE OF MEDICINES. 

nary body, consisting of sulphur and four equivalents of oxygen. 
Its name of course must be changed with the view of its nature, 
and, instead of sulphate of soda, we are to call it, according to one 
chemist, sulphatoxide, and according to another, oxysulphion of 
sodium. Now, if all this were anything more than mere supposi- 
tion; if the new compound radical, which they propose to call 
sulphatoxygen or oxysulphion, or any one of its congeners, had ever 
been obtained in a separate state, or had been positively proved 
to exist by a demonstrative course of inductive reasoning, however 
we might regret this rooting up of our deeply seated notions, and 
however inconvenient some of us rather advanced in life might find 
it to impose so many new and hard names upon our already over- 
burdened memory, we should be compelled to submit, and at least 
to assume the appearance of rejoicing at the progress of science. 
But to be put to all this inconvenience merely for the gratification 
of a speculative disposition in others ; to be compelled to go back 
to the learning of words and definitions, merely that certain scien- 
tific writers may have the opportunity to display a peculiar skill 
in conjecture; I submit it to you, gentlemen, if this is not rather 
hard ; and, when I tell you that, in addition to the two names for 
almost every salt which you at present learn, you will have to com- 
mit a third to memory, should the new notions prevail, I am sure 
that, fond as from your time of life you may be of novelty, you will 
agree with me in wishing, that this theory of mushroom growth 
may prove also to have a mushroom duration Luckily, the 
strength of our chemical Samson is enlisted against it; and, if it 
do not fall under his sturdy blows, it must be much more deeply 
rooted than, both for your sakes and my own, I hope it may prove 
to be.* 
Botany, another of the auxiliary sciences of materia medica, is 

* Dr. Robert Hare was at that time professor of chemistry in the Univer- 
sity of Pennsylvania. 



ON THE CHOICE OF MEDICINES. 181 

subject to the same vexatious incouveuience. This, too, is made an 
arena upon which the lovers of notoriety, and the lovers of change, 
may perform their feats before the public. One can scarcely open 
a new book upon the subject, without finding new divisions and 
subdivisions of genera, translations of plants from their old snug 
site in the arrangement to another deemed more appropriate, and, 
as a necessary tail to these innovations, a long list of new and bar- 
barous names to be committed to memory. As if this were not 
sufficient, each succeeding writer thinks he has as good a right to 
make a name as his predecessor, and, the propriety of change being 
once admitted, proposes a designation of his own, and thus occa- 
sions to the learner, not only the labour of committing two new 
words to memory, but also the embarrassment of a choice between 
them. They who have been under the necessity of studying the 
botanical history of cardamom, know, to their cost, how numerous 
have been the changes of opinion as to the character and proper 
designation of the plant producing it. After various fluctuations 
of sentiment, and the adoption successively of the generic names 
of Amomum, Elettaria, Matonia, and Alpinia, botanists seemed at 
length to settle down upon the last, and it was hoped that the 
learner might now be left at rest. You will be sorry, however, to 
hear that the end has not yet come ; for the Edinburgh College, in 
the last edition of their pharmacopoeia, style the plant after Ros- 
coe, Renealmia, and it is highly probable that other changes are in 
store. 

But, to relinquish the sportive tone, I must say to you, gentle- 
men, in sad seriousness, that I consider this disposition to change 
a great evil. Independently of the loss of time and labour in learn- 
ing new names and new forms of things when the essence remains 
the same, we are thrown by it into a state of never-ceasing unset- 
tlement, and come at length into the danger of feeling that there 
is nothing stable under our feet; that all which we have taken for 
truth may be nothing but false observation, or ingeniously devised 



182 ON THE CHOICE OF MEDICINES. 

hypothesis ; that, in fine, neither in physics nor morals is there any 
principle on which we can repose in undoubting and unwavering 
reliance. Scarcely any tone of feeling, whether in relation to the 
general interests of science, or to our own individual interests now 
and hereafter, can be worse than this. Without the restraint of 
firm principles, we become the sport of our fancy and passions; 
and it seems to me that, in the course of affairs in this country, 
such an undercurrent may be perceived, through all the stillness 
upon the surface, setting strongly towards some great, though un- 
known catastrophe. To counteract this current should be the busi- 
ness of every well-meaning man, and every patriotic citizen; and 
in no way, I think, can we so effectually attain this end as by determ- 
ining to hold fast to tried maxims and principles ; to resist firmly 
the seductions offered, both from without and in our own hearts, 
to the excitements of novelty and change ; and, when something 
new, of whatever nature, or in whatever relation, is offered for our 
adoption, to consider it most carefully in all its bearings, and to 
submit it cautiously to the test of experience, before heartily adopt- 
ing it, and especially before allowing it to displace an old principle 
from our respect or affection. 

You will perceive the bearing of these remarks upon the subject 
immediately before us. There are few things in which we are more 
apt to be led astray by the love of novelty than in the choice of 
medicines. All the most valuable and best tried instruments of 
our art are but too apt to fail in obstinate cases of disease ; and, 
even where success is probable or certain in the end, it is too often 
slow. In our extreme anxiety and impatience, we are ready to 
catch at a,ny aid that is confidently held out to us ; and, as most 
new medicines or preparations come recommended by a never- 
failing success in the hands of their introducers, we are not without 
seemingly reasonable hope of advantage from them. In addition 
to the mere inducement of novelty, we have the uneasiness under 
a heavy responsibility, and the fear that we may leave some pos- 



ON THE CHOICE OF MEDICINES. 183 

sible means untried of acquitting ourselves well in the almost fear- 
ful charge entrusted to us. Many yield to these influences, and 
make an eager trial of the new remedy. Perhaps accident, and 
those various circumstances which very frequently conspire to pro- 
duce a false conclusion as to the efficacy of a particular treatment, 
may work in its favour ; and we may thus, from a partial experience, 
acquire a confidence which may lead to its further and more exten- 
sive employment, until the tide of fortune changes, and repeated 
failures at length conduct us back to a just estimate of its value. 
The continuance of the same causes leads subsequently to similar 
results. With each newly proposed remedy, we run the same 
round of promising trial, partial success, and ultimate disappoint- 
ment; and the consequence sometimes is, that, drawn off from 
established methods of cure in pursuit of these ignes fatui, we find 
ourselves at last unsettled in practice and opinion, distrustful of 
the old without having acquired confidence in the new, and almost 
ready to surrender in despair all reliance upon the efficacy of medi- 
cine. Of newly proposed remedies, many are mere revivals of those 
once employed, but afterwards neglected or forgotten ; while, of the 
remainder, the great majority are wholly incapable of maintaining 
the place into which they have been temporarily elevated. Since 
the period at which I commenced the practice of medicine, iodine 
and its compounds are almost the only really new remedies which 
have come into general use ; for morphia, quinia, strychnia, crea- 
sote, etc., are merely the isolated active principles of medicines 
before well known ; while numerous substances, original or revived, 
for which high claims were asserted, are either altogether forgotten, 
or treated as objects rather of curiosity than real service. Let me, 
therefore, strongly urge you always, in your choice of medicines, to 
lean decidedly towards those of established reputation. Do not 
neglect the old tried servants of your professional fathers, for the 
crowd of younger applicants for your favour, whose only claims are 
a new face, a good deal of pretension, and a list of recommenda- 



184 ON THE CHOICE OF MEDICINES. 

tions from persons you do not know. But, at the same time, I am 
far from wishing to confine you to the paths before trodden, and to 
close the access to something higher than we have yet attained. 
Well regulated efforts to widen the circle of the useful are highly 
laudable. What I wish to impress on you is, that you should not 
adopt a medicine because it is new; that you should, in fact, con- 
sider its novelty as a ground of suspicion, and should admit it into 
your confidence only upon strong and trustworthy recommendation, 
and after a strict examination into its merits. 

I have only one other limitation to propose to you, in your selec- 
tion of medicines. Never, under any circumstances, employ those 
of which the composition is kept secret. Such medicines will be 
constantly urged upon your notice with the highest pretensions. 
The preparer will offer them to your acceptance, and humbly beg 
for a trial, either in the hope of subsequently obtaining your recom- 
mendation, or at least with the intention of making use of your 
name. Your patients, yielding to the solicitations of friends, or 
prompted by their own secret hopes, will press you to permit or 
authorize their use. But steel yourselves against all such solicita- 
tions, and resolve that your hand, at least, shall not be the one to 
fix a stain upon the fair fame of your profession. You may justly 
ask the reasons for such a positive rejection of remedies of asserted 
value. Is it not obvious that, so long as their nature and prepara- 
tion are concealed, you can have no such certain knowledge of 
their mode of action as to justify you in their employment to meet 
any given indication 1 It may be argued, on the opposite side, that 
we are equally ignorant of the precise composition of many other 
well-kinown remedies as they come from the laboratory of nature; 
that the secret medicine in question may have been so frequently 
tried, under every variety of circumstance, that, in relation to its 
physiological and therapeutical effects, it is as well known as those 
of a more legitimate character ; and that we have no right to re- 
ject offered means of relief to our patient, however irregular these 



ON THE CHOICE OF MEDICINES. 185 

means maybe. But the answer is clear; that a substance pro- 
duced by nature, even though its composition may not be known, 
can always be relied on as identical, if obtained under similar cir- 
cumstances, and treated in the same manner ; while, in relation to 
the secret medicine, you can have no such confidence, as its mode 
of preparation depends on the caprice or varying views of an indi- 
vidual, not always of the best character; and, even though one 
parcel of it may have been profitably employed under certain cir- 
cumstances, you can have no satisfactory proof that another parcel 
will have the same effect. But there are other and higher grounds 
for your utter rejection of such medicines. By allowing yourselves 
to be drawn into their use, you would give to unprincipled men 
the opportunity of citing your example as a rule for others. No 
matter how careful you may be, in employing the nostrum, to 
confine it within perfectly safe limits; no sooner will you have 
touched the vile thing, than the fact will be proclaimed wherever 
your name has influence, you will be emblazoned in advertisements, 
and heralded in placards as its indiscriminate patron, and will 
thus, even against your wishes, be made an instrument for extend- 
ing its general reputation, and establishing it in the public confi- 
dence. After this, it will be in vain that you may disclaim your 
asserted favour. You cannot but acknowledge that you have used 
it ; and all else that you may say will be ascribed to professional 
or personal jealousy, and will tend still further to benefit the em- 
piric, by the opportunity it will afford him of exhibiting himself to 
the public as a persecuted man. 

Under these circumstances, would not your first inconsiderate 
step be answerable for a proportion of all the mischief which may 
arise from the misapplication of the medicine ? Would you not, 
moreover, be lending your countenance to the general cause of 
empiricism? Would not the whole rabble of quacks shout out 
your name as one of their supporters ? And would not your pro- 
fession itself be in some measure degraded by this association of 



18G ON THE CHOICE OF MEDICINES. 

one of its members with such a cause ? It is highly important, 
therefore, to keep yourselves strictly within the regular limits. 
Exceed these, even though in a slight degree, and you lose all 
control over the result. You cannot calculate the evils which may 
flow from one false step. What is any possible advantage which 
may accrue, in a single case in which you might be disposed to 
employ the nostrum, compared with all this general evil ? I do 
not speak thus as a mere matter of course, but with a strong sense 
of the duties of our high calling, and of the imperative obligation 
of every member of the profession to avoid doing anything which 
might degrade its character, and limit its sphere of usefulness. I 
beseech you, gentlemen, as you regard this character, as you value 
your own reputation and future comfort, to keep yourselves clean 
from every taint of empiricism. Of what consequence is a little 
pecuniary profit ? nay, of what consequence are heaps of gold ac- 
quired by such imposture ? Does not a feeling of disgrace cleave 
to their possessor through his whole future life ? Does not the 
finger of scorn point to him while he lives ? and, at his death, does 
he not leave an inheritance of shame to his descendants, so that 
his son and his son's son must blush at the mention of his occupa- 
tion? I presume, gentlemen, there is not one among you who 
would not rather be the offspring of the humblest wood-chopper 
or sweeper of the streets, if an honest man, than of the most pros- 
perous quack who ever revelled in wealth, purchased by a base 
course of deception, and at the cost of injury to thousands. You 
would shrink, of course, from leaving to those who may come after 
you a legacy, which you would look upon as a disgrace from one 
of your own predecessors. But I have been led away from the 
point to which I wished especially to direct your attention. There 
is no danger of your becoming quacks ; there may be some, that, 
unless carefully on your guard, you may afford that degree of coun- 
tenance to quackery which is implied in the occasional employment 
of secret nostrums. Let me again urge upon you, even at the pos- 



ON THE CHOICE OF MEDICINES. 187 

sible chance of losing a temporary advantage, to shun them alto- 
gether, and, so far as your influence may extend, to discourage 
their use by others of your professional brethren. 

I have now brought to a close those general observations, which 
I had to lay before you in relation to your choice of medicines. To 
sum them up in a few words ; I would advise that you should espe- 
cially avoid the harsher remedies where the occasion demands only 
the milder, and should give none in excessive quantities; that, 
while aiming, on the one hand, at a rational simplicity in the suc- 
cession and association of medicines, you should take care, on the 
other, not to fall into an extreme penuriousness in their use ; that 
you should exhibit an undue addiction neither to what is old nor 
what is new merely as such, but firmly hold on to the tried, until 
you can substitute something proved to be better ; that you should 
never, under any circumstances, permit a secret nostrum to enter 
into your medicinal catalogue ; and, finally, that you should receive 
as a general guide the national pharmacopoeia, without, however, 
a slavish confinement within the precise limits which it indicates. 

Having thus intimated, in general terms, what you ought to do, 
and what leave undone in the selection of your therapeutical instru- 
ments, I have only further to recommend that you should make 
yourselves thoroughly acquainted with these instruments, especially 
in all their practical bearings. To obtain such knowledge it is, in 
part, that you are here assembled ; and to facilitate your acquisi- 
tion of it is the agreeable duty which will bring me before you this 
winter. Permit me once more to welcome you heartily to our joint 
labours. 



LECTURES, 
INTRODUCTORY 

TO THE COURSE ON THE 

THEORY AND PRACTICE OF MEDICINE, 

IN THE 

UNIVERSITY OF PENNSYLVANIA. 



INTRODUCTORY LECTURES 



THEORY AND PRACTICE OF MEDICINE. 



Preliminary Remarks, 

The four following lectures were delivered, between the years 1850 
and 1860, as introductory to my course upon the Theory and Practice 
of Medicine in the University of Pennsylvania. Their object was to 
point out to the pupil the spirit and method in which his studies should 
be conducted, and to put him in possession of such views, as to the 
nature, extent, and objects of this department of medicine, as might 
inspire him with zeal in its pursuit, and generate in him sound prin- 
ciples to govern him in its practice. Though there is almost necessarily 
some repetition in the lectures, yet each will be found to have its own 
scope ; and, together, they constitute a system in which, I venture to 
hope, the student will find principles and motives sufficient, if allowed 
their due influence, to insure his entrance into the profession, not only 
qualified for its duties, but fitted also to dignify and adorn it by his 

demeanour and conduct. 

(191) 



LECTURE I. 



DELIVERED OCTOBER 11th, 1850. 



The Theory and Practice of Medicine. 

Allow me, gentlemen, to offer you a cordial greeting, on this 
occasion of our first meeting in the new relation in which I stand 
to the medical class. Hitherto you have known me as a teacher 
of materia medica. It has pleased the authorities of this school 
to transfer me from that position to the chair of the theory and 
practice of medicine. I ask of your indulgence a few minutes of 
attention, while I refer to my own part in this change, and endea- 
vour to deduce reasons, which may render your judgment upon 
my future efforts more lenient than if based solely upon their 
merits. 

You are aware that the professorship I now fill became vacant, 
soon after the close of the last session, by the resignation of Dr. 
Chapman, whose failing strength induced him to withdraw from 
its onerous duties, after a career of honour and usefulness, never 
surpassed in the medical history of this country. In the move- 
ments which afterwards took place, in reference to the filling of 
the vacancy, I was quite passive. An honourable ambition might 
suggest that the professorship of the practice, occupied as it had 
been by men so illustrious, held a somewhat more elevated place 
in public estimation than that of materia medica ; and the con- 
(192) 



THEORY AND PRACTICE OE MEDICINE. 193 

sideration was not without weight, that in the former a new field 
was opened, calculated to stimulate energies and industry, which, 
without some fresh excitement, might perhaps slumber in the hebe- 
tude of increasing age. On the other hand, however, were the 
reflections, that with my existing duties I was quite familiar ; that 
to fulfil them it was only necessary to keep up with the advancing 
tide of knowledge; that rest rather than increased labour was 
suited to my time of life, or at least soon would be ; and that, in 
making a change, I might be abandoning a position to which suffi- 
cient trial had shown me to be in some degree adequate, for 
another in which I might not prove equally useful, or give equal 
satisfaction. The motives for a change were insufficient to out- 
weigh those of a contrary character; and having, therefore, no 
personal ends to answer, I had no other wish, in reference to the 
future arrangements, than that they might be such as would con- 
duce to the advantage of the school. 

To my colleagues and to all others concerned, when interro- 
gated on the subject, I freely made known these sentiments ; de- 
claring truly that I was personally indifferent whether, in the 
approaching election, another or myself should be chosen, that I 
was desirous only that the true interests of the school should be 
consulted, and that, not being the best judge of my own qualifica- 
tions, I should take no step in the matter, but leave it altogether 
to the wisdom of those in whose charge the institution was placed. 
Should they believe that I could best serve the school in the de- 
partment of materia medica, I would cheerfully persevere in my 
former path of labour, and cordially greet any new colleague whom 
the trustees might elect to the vacant professorship. Should it, 
on the contrary, be thought that I could do better service in the 
practical chair, I would acquiesce in the decision, and exert my- 
self, to the extent of my capacity, to fulfil its various and burden- 
some requisitions. 

Under these circumstances, the choice, as you are aware, fell on 

13 



10 i THEORY AND PRACTICE OF MEDICINE. 

myself; and I should not be doing justice to my feelings on the 
occasion, if I did not confess to you that this mark of confidence 
was in the highest degree gratifying to me, though involving much 
of labour, of sacrifice, and of misgiving on my part. 

And now, gentlemen, you will, I hope, be disposed to judge me 
leniently in my new sphere of duty, and, should the result of my 
efforts fall short of your expectations, or of the just demands of 
the position, will at least acquit me of undue presumption. 

There is another consideration, which, in justice to myself, I 
must beg of you to bear in mind, in forming your estimate of the 
ensuing course of lectures. You will necessarily compare them 
with the past. Even those of you who have not enjoyed the 
opportunity of listening to my predecessors^have yet heard, and 
still hear the prolonged echo of their praises, and have in your 
own mind formed a standard of excellence, in connection with this 
chair, by which you will naturally be disposed to judge its present 
occupant. But remember, gentlemen, that these were men the 
most eminent in their profession whom this country has produced, 
whose names are set like priceless gems in our history, and who, 
standing in the morning light of medical teaching on this conti- 
nent, loom in magnificent hues on your admiring vision. Drs. 
Morgan, Kuhn, Rush, Barton, and Chapman, have successively 
held the professorship of the theory and practice of medicine in 
this school. Here, in this very spot, is enthroned the reputation 
of these distinguished men. A successor approaches the place 
illuminated by such recollections, and is for the moment invested, 
in the imagination of the spectator, with the lingering effulgence. 
You will admit with me, gentlemen, that this is a most trying 
position. In the cold presence of reality, the unsubstantial glory 
soon fades away, and the new-comer stands in the severe out- 
lines of truth, with no colouring from the pencil of fancy; nay, 
dimmed and beclouded to eyes which have been dazzled by the 
previous brightness. This trial I am now to undergo. May I not 



THEORY AND PRACTICE OF MEDICINE. 195 

ask of you, gentlemen, to close your eyes firmly on the past; and, 
in judging of my efforts, if indisposed to a partial indulgence, at 
least to view them in their own true light, and not through the 
medium of an impairing contrast? 

With these preliminary observations, the personal nature of 
which may perhaps be excused in consideration of the novelty of 
my position, I will proceed at once to the proper object of this 
address ; the introduction, namely, to the notice of the class, of the 
course of instruction which it has become my duty to deliver. 

The subject of that course is, as you know, the Theory and 
Practice of Medicine. Under this comprehensive title is pro- 
perly included all that relates directly to the cause, symptoms and 
signs, nature, effects, treatment, and prevention of internal dis- 
eases. External diseases are considered as belonging in general 
to surgery. Custom has somewhat curtailed the limits of the 
theory and practice as just defined, by separating the affections 
peculiar to the female sex and to early infancy, and also those con- 
nected with syphilitic contamination, giving the former to the 
obstetrical teacher, and the latter to the surgeon. But, even with 
this limitation, the subject is of vast extent and importance, re- 
quiring the devotion of time, labour, and zeal for its mastery, and 
imperiously demanding such devotion, on the part both of those 
who teach and those who learn, under the highest sanctions of 
duty. 

Conscientious convictions on these points, in the outset, are 
essential to you and to myself, in our respective capacities of pupil 
and teacher. Should we enter upon our approaching duties with 
d arrow views either of their extent or their obligation, what is to 
compel us into the exercise of that patient industry, that painful 
self-denial, that devotion of our whole thoughts and faculties, which 
are essential to the right end ? What is to guard us against the 
ever-present seductions of indolence and of pleasure? I would 
imbue you, therefore, gentlemen, and I would most earnestly my- 



190 THEORY AND PRACTICE OF MEDICINE. 

self desire to be imbued, with a full sense of the vast extent of our 
field of labour, and of the great, I might almost say the awful re- 
sponsibility connected with its cultivation. Let me endeavour, in 
a very few words, to set these points before you in somewhat of 
their intensity of truth. 

When I tell you that there is scarcely anything in nature, having 
relation with our bodies for good or for evil, whether a substance, 
a process, a mental act or emotion, or even the negation of a posi- 
tive agency, which may not become a cause of disease ; that, in 
reference to the nature of disease, the most numerous, intricate, 
and subtle experiments have but opened a prospect here and there 
into its great mysteries, which have occupied the most profound 
minds for ages, and given rise to countless disquisitions ; that the 
symptoms and signs of disease embrace every variety of external 
aspect and movement exhibited by the sick, every indication offered 
to the ear, the touch, or the eye, of internal change, and every de- 
duction of the judgment from whatever source as to the existing 
condition of the deranged system ; that the effects of disease are 
almost as numerous and diversified as the morbid states or pro- 
cesses to which the body is liable, these being very often only the 
results of antecedent morbid states or processes; that, in the 
treatment of disease, agencies of the most varied character, includ- 
ing not only all the bodies usually called medicines, but all the 
influences capable of favourably modifying the systemic actions, 
are to be employed with variations in degree, mode of preparation, 
application, and association, as numerous as the diversities of the 
human constitution in the healthy and morbid state ; that, finally, 
in the prevention of disease, it is necessary to bring a knowledge 
of its causes, and of the influences capable of removing, neutral- 
izing, or resisting their operation, to bear upon our decisions in 
the different cases presented; — when all these facts are considered, 
you will, I am sure, agree with me, that the subject of the theory 



THEORY AND PRACTICE OF MEDICINE. 191 

and practice of medicine offers scope for all the time, energy, in- 
dustry, and talent that you can possibly devote to it. 

But is its importance commensurate with its mass ? May it not 
be that all this vast amount of knowledge is mere useless lore ; the 
accumulation of rubbish from times past, which a more enlightened 
intelligence rejects as useless; an Augean pile from the crude 
digestion of ages, which, instead of being laboriously stored in the 
memory of the student, rather needs the power of some Herculean 
genius to wash it away into oblivion ? The empirical pretender to 
a miraculous knowledge and command of nature would probably 
answer this question in the affirmative; the man of sense and 
honesty would emphatically answer, no ! Of the immense value 
of medical knowledge, if it is what it purports to be, there can be 
but one opinion. To relieve pain, to save life, to preserve health ; 
these are aims, the importance of which can scarcely be over- 
stated. The simplest terms in which they can be expressed con- 
vey at once and irresistibly to the judgment, the full sense of their 
inestimable value. No exaggerations of language, no ornaments 
of rhetoric, can render them more impressive. The question, then, 
is, does a knowledge of medicine, as at present taught, really con- 
tribute toward those great results, which are its professed aim 
and end ? 

To answer this question rationally we must have recourse to the 
two great principles by which truth is tested ; to the judgment, 
namely, and to experience. In the first place, what is the conclu- 
sion of the judgment ? From the beginning of history, in all ages 
and in all civilized countries, men, among the first certainly in 
mental powers and attainments, have devoted themselves to the 
observation of disease, and to the recording of the facts observed. 
While the process of collection has thus been going on, the accu- 
mulated material has been from time to time subjected to a careful 
scrutiny, and the false and useless, which must ever, while human 
judgment is fallible, and human passions have their ordinary influ- 



108 « THEORY AND PRACTICE OF MEDICINE. 

ence, mingle in greater or less proportion with the true, have been, 
in a considerable degree, separated, thrown aside, and forgotten. 
The medical knowledge of the present times is thus the slow 
growth of centuries, I might say of thousands of years, during 
which, as in the growth of living bodies, an intellectual digestion 
and nutrition have been going on ; the useless and effete being 
thrown off, at the same time that the useful and efficient has been 
assimilated ; the latter, however, constantly increasing in amount, 
and destined to increase hereafter, until our science shall become 
mature, and nature have yielded to human investigation all that 
she possesses of the preservative and remedial. 

Now I would ask any reasonable man, if the results of these 
ages of the industrious working of intellect is likely to have been 
in vain ? if the best talent of all time and all countries can have 
been employed in heaping together an empty pile of nothingness, 
to be puffed away by the breath of ignorant enthusiasm, or char- 
latan pretension ? Is it possible that the two hundred thousand 
physicians, who now have under their charge the health of the 
civilized world, men of the best education and highest intellect, 
many of whom are the glory of the country, and the ornament of 
the age in which they live, should be so far mistaken as to yield 
their undoubting confidence to a huge mass of error; that they 
should have devoted their lives to the prosecution of vain shadows; 
or that they should recklessly sport with the lives of others, under 
a false pretence of knowledge ? 

It may be said that medicine, like certain false religions, is a 
great system of fraud, got up by the self-interest of shrewd but 
unprincipled men, believed in by the multitude of uninitiated dis- 
ciples, and used by the few wiser heads intrusted with its mysteries, 
for the purposes of their own lust of wealth or power. But only 
stupidity or malignity could bring such a charge against it. Where 
are the mysteries of our profession ? Are not the magazines of 
knowledge open to all who choose to enter ? Instead of conceal- 



THEORY AND PRACTICE OF MEDICINE. 199 

merit or mystification, are there not interpreters ever ready to make 
clear and easy whatever may seem obscure or difficult, so far at 
least as discovery has yet advanced ? Do we profess to have 
secret depths which ordinary intellect cannot fathom ? Do we 
claim certainty or universality of knowledge, or infallibility of judg- 
ment? Or, rather, do we not profess openly that our science is yet 
imperfect ; that, though much has been learned, yet much still re- 
mains to be learned; that, though we can do much good, we can- 
not do all good ? Do we not proclaim that we seek only for truth ; 
that we are open to its reception from whatever source it may 
come ; and that our greatest zeal is to enlarge the boundaries of 
our knowledge, and the extent of our capacity of usefulness ? 

Ours is no special theory originating in the excitement of an 
insane imagination, the suggestions of an extravagant vanity, or 
the promptings of interested ambition or covetousness. It is the 
interest, and has been the trickery of charlatanism in all its branches, 
to represent the genuine practice of medicine as a peculiar system, 
old, worn out, effete, good perhaps in its day, but in all respects 
inferior to the new system of some inspired founder, some new 
medical dispensation, which is to supersede all former modes of 
practice, and to continue unimpaired until the latest time. You 
know, gentlemen, that we acknowledge no special system. Imagi- 
native minds in our profession have from time to time put forth 
hypotheses ; many of them, it is true, futile ; many with but partial 
glimpses into yet undiscovered truths : but these are received for 
what they are worth, examined, sifted, and partially or wholly 
rejected, as they prove to be more or less founded in truth, or 
altogether baseless. It has been a war cry of homoeopathy to call 
us allopathists ; and some physicians have been weak enough to 
recognize the name. But we are not allopathists. We proclaim 
entire freedom from the bonds of all narrowing hypothesis. We 
are, as I have already asserted, honest seekers after truth, willing 
to take it wherever it can be found ; to pick it up even from the 



200 THEORY AND PRACTICE OF MEDICINE. 

kennel or the common sewer of quackery, if it happen to be seen 
sparkling amidst the filth. 

Our profession, therefore, is not a pretence. We are all firm 
and honest believers in it. Is not this obvious to the most cursory 
inspection, if but impartial ? Look abroad among the practitioners 
of medicine. Do you not find many of them among the most re- 
spected and honoured ; joining in all liberal and benevolent schemes 
to the extent of their means ; living consistently with their profes- 
sion ; subjecting their dearest friends, their own families, them- 
selves, to the same treatment which they apply to their patients 
generally? And then, inquire into their secret walks. Where 
are they but among the poor and wretched ? How many instances 
are of daily occurrence in which wants are relieved, suffering alle- 
viated, and life saved, by their unpaid and even unknown ministra- 
tions ! No, gentlemen, we are not deceivers. We are, as a body, 
not likely to be deceived. If these are facts, then is there reality 
and truth in medicine. 

What has been hitherto said refers rather to authority and opin- 
ion than to positive proof. I have asked your belief in our science 
from your confidence in those who have preceded you. I have 
appealed to your judgment, upon the basis of faith in the existence 
of common sense, honour, and virtue among men. But the evidence 
of experience may also be adduced. 

To the practitioner himself the proofs of the efficacy of his mea- 
sures are too frequently offered to admit of doubt. Every day he 
witnesses cases of suffering, in which relief follows almost imme- 
diately the use of appropriate remedies. Chronic affections fre- 
quently came under his notice, which, after a long course of steady 
deterioration, with no hope of spontaneous amendment, commence 
a course of amelioration from the moment that the influence of 
treatment is felt; and it often happens that the period at which 
enefit will accrue may be confidently predicted. It is his great 



THEORY AND PRACTICE OF MEDICINE. 201 

happiness to believe that, in not a few instances, fatal results are 
averted through his instrumentality. 

It is true that most diseases, if left to themselves, and some- 
times even under positively injurious treatment, will sooner or later 
terminate favourably, through the inherent powers of the system. 
Hence the frequent apparent success of irregular and unskilful 
practitioners. It is in fact on this basis, and on the prevalent 
ignorance of the truth just stated, that the whole edifice of quack- 
ery, in all its forms, mainly rests. The spontaneous curability of 
most diseases is to the medical charlatan, what the regular and 
calculable, but generally unlooked for recurrence of certain natural 
phenomena is to the juggler and mountebank. A traveller from 
civilized life, thrown among savages, predicts an eclipse of the sun 
or moon as the result of his own command over nature, and gains 
credit for what he claims by the fulfilment of his prediction. The 
empiric knows that a disease will in all probability end favourably 
within a certain time, and, aduiinistei'ing his nostrum, claims the 
result as a proof of his own skill. Sometimes, no doubt, he is him- 
self deceived, and has a real faith in the efficacy of the means em- 
ployed. But, even in these spontaneously curable cases, where, as 
a general rule, the ignorant practitioner does nothing, or does only 
harm, the well-instructed physician often finds that he can lessen 
the degree, and shorten the period of suffering. He too often 
witnesses the miserable leavings of quackery, the sufferings unne- 
cessarily severe, the disease unnecessarily protracted through the 
want of proper and efficient means, to be able to hesitate in his 
own opinions. But this experience of his own cannot be made 
also the experience of others ; the quack claims equal credence for 
his assertions ; and unfortunately the gullible public have no other 
means to judge between them than the too often wanting quality 
of common sense. Our individual testimony might not, therefore, 
be received, and it is necessary to have recourse to results which 
are obvious to multitudes. 



202 THEORY AND PRACTICE OP MEDICINE. 

For yourselves, my young friends, nothing more would be want- 
ing to conviction than a close attendance, for a single season, upon 
the wards of our hospitals. You there have the opportunity of 
seeing patients, who had been gradually becoming worse and worse 
for weeks or months, or who, it may be, had been suffering for 
years, beginning to improve under the means employed, and regu- 
larly going on to health, often at the very time, and in the very 
manner predicted by the prescriber. The bloodless young woman, 
with her palpitating heart, her embarrassed breathing, and nervous 
symptoms of extreme violence, is put on the use of the prepara- 
tions of iron, and, in from three to six weeks, leaves the hospital, 
rosy, cheerful, and in full health. The bloated, dropsical patient, 
whose disease had been slowly advancing for months, takes his 
fox-glove, or cream of tartar, or some other equivalent remedy, 
and rapidly recovers under its influence. Every variety of chronic 
inflammation you behold yielding to the careful administration of 
mercury. Skin diseases, which have been the misery of their victim 
for years, perhaps rendering life itself burdensome, vanish before 
your eyes under the use of arsenical preparations. I might go on 
multiplying such cases, and might confidently appeal, for the accu- 
racy of my statements, to those of you who have enjoyed the requi- 
site opportunities. 

But evidence still more general is not wanting. Every one 
knows that intermittent fever and scurvy, which were of old most 
formidable and destructive diseases, are completely under the con- 
trol of remedies ; and that cholera, so tremendously fatal if neg- 
lected, may almost always be cured if subjected to proper treatment 
in its earliest stage. The records of history are full of the devas- 
tations of small-pox, which has now been stripped of its terrors 
through the instrumentality of the physician ; and a scourge of the 
vicious, at one period scarcely less fatal than that terrible disease, 
acknowledges in almost every instance the efficacy of medicine. 

The grand truth, however, that speaks more strongly than any 



THEORY AND PRACTICE OF MEDICINE. 203 

other to the public ear, is the well-known fact, that the rate of 
mortality has greatly diminished, and the general duration of human 
life greatly increased, within the period of time that has witnessed 
the most rapid advance of medical science. Something of this, it 
is true, may be due to the general progress of civilization, to the 
wide diffusion of the comforts of life among the poorer classes, to 
the better knowledge of the principles of hygiene, and the conse- 
quent removal or correction of many of those causes of disease 
which were once so prevalent ; to cleanliness, for example, in 
living, to an improved diet, to better ventilation, and to the pre- 
vention of morbific effluvia, whether from crowded human beings 
or from paludal sources. But these ameliorations are in great 
measure owing to the influence of enlightened medical opinion; 
and, even setting the results of this aside, enough remains of the 
direct effect of our art, in the more certain cure and prevention of 
disease, to give it, in every impartial mind, the credit of great effi- 
ciency. 

With these truths, then, young gentlemen, before you — that the 
theory and practice of medicine embraces a vast amount of knowl- 
edge, and that this knowledge is available for the most important 
practical purposes — you will confess yourselves bound, by every 
principle that can influence a rational and responsible being, to 
use your utmost endeavours to qualify yourselves for its proper 
application; and will not fail to co-operate with me, during the 
coming session, in earnest efforts for this end. 

But I would not have you to be discouraged by the amount of 
various knowledge that claims your attention. It is not to deter, 
but to stimulate and inspirit you, that I have portrayed in some- 
what vivid colours the difficulties before you. More is not required 
of us than we can perform by a reasonable exertion of our faculties, 
and a fair use of our opportunities. Impossibilities, or results at- 
tainable only by the sacrifice of comfort and health, are required 
of no man. Besides, our attainments are often necessarily limited 



204 THEORY AND PRACTICE OF MEDICINE. 

by circumstances quite beyond our control. In this country, the 
habits of business permit only the devotion of a certain limited 
time, as a general rule, to preparation for active life. Our whole 
system of education is based on this fact. This is true of medi- 
cine, as of every other branch of professional knowledge. A cer- 
tain period is fixed for study; not so long as our best interests 
would demand, but as long, it is thought, as can be spared from 
practical pursuits. If, during this period, you devote a faithful 
attention to the acquisition of knowledge and skill, you will be 
justified to your consciences, though still more or less deficient. 
No man is in this respect perfect. All have deficiencies; and, 
through life, no matter how long it may last, our constant en- 
deavour should be directed to their correction. You will learn, 
before many years, that your graduation in medicine is simply the 
era, at which you are to begin your own self-guidance in the pur- 
suit of professional knowledge, and by no means the evidence of 
your having attained sufficient knowledge already. Be not alarmed, 
then, by the apparent difficulties of your path. Let not the fear 
of being unable to acquit yourselves creditably, discourage you 
from availing yourselves of the best advantages in your power. 
We do not ask of you what you cannot well perform, what cannot 
be readily accomplished by ordinary abilities and a willing spirit, in 
the time allotted for preparation. 

In order that the young men attending our school may have the 
largest practicable opportunities for learning, we have lengthened 
that portion of the period of study, during which you have the aid 
of a regular system of teaching. In other words, the courses of 
lectures in this school have been gradually prolonged of late years; 
and, instead of being confined to four months as originally, are now 
extended to six. This was, in fact, nothing more than was neces- 
sary to keep us from retrograding from that position, which, as a 
school, it has been our ambition to maintain. The science of me- 
dicine has been greatly enlarged within the last fifty years ; and to 



THEORY AND PRACTICE OF MEDICINE. 205 

teach it as thoroughly as it was taught before that period requires 
a longer time. If four months were but sufficient then, six months 
are certainly requisite now. It is vain to say 'that the former period 
is amply sufficient ; that, by crowding much upon the student, he is 
compelled to exert himself more ; and that he will learn as much 
in the shorter as the longer term. The judgment refuses to listen 
to such puerile sophistry. You might, on the same principle, 
lessen the period to three months, two months, or even a single 
month ; and at last it would be reduced to a vanishing quantity, 
equivalent to the homoeopathic dose, and just about as effectual. 
There would be some consistency in such diminution by the dis- 
ciples of Hahnemann ; but it would not do for those who profess 
to be guided by reason and common sense. 

It may be said that the six months' system, though required by 
the interests of the profession, is unsuited to the condition of the 
country. Whether this is so or not can be ascertained only by 
trial. So far as the experience of this school has hitherto gone, it 
has been in favour of the extension of the term. We have never 
been so prosperous as on the average of the last few years.* 

That it is beneficial to the student, we have not only the infer- 
ence of the judgment, but the positive results of our own observa- 
tion. Assuredly, our classes of graduates have never been so com- 
petent as since the extension of the courses. 

There is some honour, too, gentlemen, in graduating where the 



* Though this statement was true at the time it was made, yet it soon 
became obvious, after the first enthusiasm of the profession, under the influ- 
ence which gave rise to the American Medical Association, had subsided, 
that our school would be unable to sustain itself in the degree of expansion 
which it first attempted, and that the six months' course must be abandoned. 
In contracting the course, however, the University retained five months of 
instruction, and has continued to do so to the present time. This period 
exceeds the old length of session by about one month. 



20G THEORY AND PRACTICE OF MEDTCTNE. 

requisitions are high. I have never heard one of our alumni say 
that he repented having attended during the prolonged session. 

But I would repeat again, that, while we are unwilling to pros- 
titute the honours of this school to wilful ignorance and notorious 
incompetence, we have no wish to be severe with the pupil ; but, 
on the contrary, feel a parental interest in his success, and expect 
nothing from him which is in any degree beyond his power. You 
will, therefore, so far from being discouraged by the picture pre- 
sented to you, but feel yourselves inspired with greater zeal and 
energy, and will enter on your winter's course, determined to exert 
yourselves faithfully, not for your own good only, but for the honour 
of the school of your choice, and, may I not add, for that of your 
teachers also. 

It will be proper for me, before closing this address, to make 
you acquainted with the outlines of the plan upon which the 
ensuing course of lectures is to be conducted. 

The main objects will be to present to the student the promi- 
nent and most important points of the subjects to be treated of, to 
render these perfectly clear to his understanding, and to impress 
them as forcibly as possible upon his memory by suitable illustra- 
tions whenever practicable. My wish is to go over the whole 
ground of the theory and practice during the session. This is a 
vast region, with subdivisions having innumerable diversities of 
boundary and of surface, and presenting objects of more or less 
utility at almost every step. To survey the whole minutely, in one 
session, is obviously quite impracticable. No human power would 
be adequate to the task of description in the space of time allot- 
ted ; and, even were the task possible, no human intellect would 
be capacious and retentive enough to receive and hold all the ob- 
jects presented. There is, then, but one alternative. Either the 
lecturer must content himself with going over the ground in a 
more or less general manner; or, if he wish to consider the subject 






THEORY AND PRACTICE OF MEDICINE. 201 

in detail, and thus completely to exhaust it, he must take it up in 
sections, and treat of these severally in different sessions. 

The latter method is objectionable on more than one account. 
It destroys all unity of instruction. The student receives informa- 
tion in parcels, at distant periods, and is thus in some degree dis- 
abled from forming those general conceptions applicable to the 
whole subject, which are of great use in giving consistency, and the 
most efficient practical applicability to his knowledge. In the 
intervals he is apt to forget much that he had learned, and cannot, 
therefore, upon resuming his attendance, justly appreciate the 
bearings of the past upon the present instruction, nor enjoy fully 
those advantages, which, in the ascent to knowledge, are always 
gained by mounting regularly and continuously, making each step 
the means of gaining the one immediately above it. 

But a more serious objection arises from the regulation of our 
school, which permits students who have attended one full course 
elsewhere, to graduate after a single course with us. Many young 
men avail themselves of this regulation, and for these the instruc- 
tion would be but half, or perhaps less than half completed. Com- 
ing hither with the expectation of being fully taught, they would 
leave us with their education unfinished, and of course, so far as 
this chair is concerned, but half prepared for the fearful encounter 
with disease to follow. 

In order that justice may be done equally to all who favour us 
with their attendance, it is necessary that the whole circle of in- 
struction should be completed in a single session. This can be 
accomplished only by adopting the former of the two plans referred 
to; that, namely, which selects the most characteristic and most 
important points of each subject, and places them with due promi- 
nence before the learner, referring him for minute details to pub- 
lished treatises and private study. This is the plan, as you are 
aware, which I propose to follow. It is, I believe, in itself the 
most appropriate for oral teaching, even if the period allowed for 



208 THEORY AND PRACTICE OF MEDICINE. 

instruction were much longer than it is. Were the lecturer to 
attempt an elaborate picture of every disease in all its relations, he 
would necessarily introduce numerous details of little importance, 
which would fatigue the attention and memory, and, like the pros- 
pect from the window of a railroad car, would leave but imperfect 
and shadowy impressions in the mind. His object should, on the 
contrary, be, to strike off accurate and vivid sketches, like those 
made by the painter with a few touches of his pencil, which often 
convey to the observer a stronger impression of the real than much 
more elaborate pictures. 

Along with the prominent and peculiar features of the several 
diseases, in all their different relations, I propose to give you the 
results of my own personal observation, reflection, and experience, 
so as to render the course in some degree characteristic. Another 
object will be to make the lectures as demonstrative as possible by 
introducing illustrative representations, such as morbid prepara- 
tions, drawings, models, etc.; in this way appealing to the eye as 
well as the ear, and seeking an entrance into the understanding 
and memory by two avenues instead of one. To enable me to ful- 
fil this latter purpose, I made during the summer, as many of you 
know, a voyage to Europe ; and I am happy to inform the class 
that it has not been altogether fruitless. I have already received 
a considerable amount of illustrative material; and, unless the 
winds and waves thwart my expectations, shall receive more in 
time for use this winter; but, as much that I ordered requires time 
for its preparation, I fear that all the results of the voyage may 
not be available during the present session. 

It seems to me that, before entering regularly on the duties of 
this place, it may not be unbecoming to pay my small tribute to 
the merits of him who filled it before me.* Happily, though with- 
drawn from an active participation in our labours, he is still among 

* The late Dr. Nathaniel Chapman. 



THEORY AND PRACTICE OF MEDICINE. 209 

us, and, in the office of Emeritus Professor of the Theory and 
Practice of Medicine, yet lends his countenance to the school, 
which he so long aided to support and elevate by his prelections. 
It would be grateful to me, could I, with a due regard to pro- 
priety, delineate to you those personal traits of our honoured 
friend, the expanded intellect, the fine imagination, the extraordi- 
nary judgment, the keen insight into character, the ready and 
cheerful wit, and, above all, the kindly feelings and excellent heart, 
by which he has ever been distinguished among those who have 
known him best. I should delight in doing justice to the quick 
flow of thought, the rapid combination, the ready perception of 
ludicrous analogies, and the copiousness of language, which ren- 
dered him one of the best extemporaneous speakers, and caused all 
that he said, whether in ordinary converse, at the festive board, 
or on more stately occasions, at once to impress with its justness 
of thought, and to delight by its sparkling pleasantry and imagi- 
native brilliancy. It would be a source to me of unmingled satis- 
faction, could I follow him in the daily walks of life, into the 
private circle, the sick chamber, the meeting of business or of plea- 
sure, and endeavour to represent to you those qualities, which, 
wherever he went, caused his coming to be hailed with pleasure, 
and gave a charm to his intercourse, which it is the happiness of 
few to command in this world of struggle and of strife. But re- 
spect for the decencies of life forbids such an analysis of living 
character, even where nothing but what is creditable would be dis- 
played; and I must content myself with referring to facts and 
incidents, which, being more or less of a public nature, are a fair 
subject for contemporary notice. 

Thirty-five years ago, when I first entered as a student into the 
medical department of this University, Dr. Chapman was profes- 
sor of materia medica, to which chair he had been elected in 1813. 
I recollect that, even then, though a young man, he was among 
the most popular teachers of the school. In 1816, he was made 

14 



210 THEORY AND PRACTICE OF MEDICINE. 

professor of the practice ; and for two winters I had the pleasure 
of listening to his instructions. It was from him undoubtedly 
that I received many of those therapeutical views, which I have 
ever since held, and which will be inculcated in the ensuing lec- 
tures. I need not tell you that he continued to hold that profes- 
sorship until his resignation last spring, a period of about thirty- 
four years. 

In the prime of his life, he attracted about him large classes of 
private pupils, for the instruction of whom he associated with him- 
self several young men, who afterwards formed with him the Medi- 
cal Institute, and most of whom have since attained eminence 
in their several departments. Professors Horner, Jackson, and 
Hodge of the University, and Professor Mitchell of the Jefferson 
School, were among his associates. ]STo medical man upon this 
continent, probably no one in the whole world, has been concerned 
in the education of so many pupils public and private ; and thou- 
sands scattered over all parts of the United States, many of them 
the most distinguished men of their respective neighbourhoods, 
hold his name in honoured and affectionate remembrance. Though 
not the oldest in years of our medical men, he certainly deserves to 
be considered, more than any other living individual, the patriarch 
of his profession in this country. The general feeling of that pro- 
fession towards him was flatteringly evinced in the year 1847, when 
he was chosen by the great American Medical Association, then 
meeting in this city, their first President; and they who were pre- 
sent on the occasion vividly remember the feelings of affectionate 
enthusiasm, with which his installation into that highly honourable 
office was greeted. 

As a practising physician, he has been scarcely less emi- 
nent, than as a teacher. In this city, he has always been 
among those who enjoyed the highest confidence of the commu- 
nity ; and, throughout the Union, his reputation as a practitioner 
was such that his opinion was eagerly sought, and many came 



THEORY AND PRACTICE OF MEDICINE. 211 

hither from great distances for the benefit solely of his advice. 
The younger members of the profession looked up to him with 
affectionate confidence, loving his warm, genial nature, as much as 
they respected his abilities ; and his aid in consultation was habitu- 
ally called in by the most distinguished among us, long after his 
advancing age had induced him to withdraw, in great measure, 
from the more active offices of his profession. 

Nor was it only in the ranks of his professional brethren, or 
among those bound to him by the strong tie of medical service, 
that he was highly esteemed. The position long held by him of 
Yice-president of the American Philosophical Society — the most 
distinguished scientific body of the continent — and that of Presi- 
dent of the same society to which he was afterward elevated, evince 
the respect entertained by the best informed men in the commu- 
nity for his general intellectual endowments. 

His career throughout, from youth to manhood, from manhood 
to old age, has been in the greatest degree prosperous and flatter- 
ing; if the most kindly regards, general respect, a wide social and 
professional influence, a reputation limited only by the bounds of 
civilization, and the highest positions not political which an indi- 
vidual can attain in this country, may be considered as evincive of 
prosperity and honour. 

Feeling the weakness of age encroaching upon him, he has spon- 
taneously withdrawn from all his active duties, and all his elevated 
positions; and now, reposing on his yet unfaded laurels, amidst 
the grateful ministrations of affectionate kindred and friends, he 
may look back to the crowded scenes of the past, and forward to 
the vast uncertainty of the future, with the calm feelings of one 
who has done his work in the day, and may hope for a peaceful 
reward, when the sun of a new and endless morning shall rise after 
the night of life. 

Our school, deprived by Dr. Chapman's advanced age of one 
of her main supports in times past, is now about entering on a new 



212 THEORY AND PRACTICE OF MEDICINE. 

stage of her long existence. Two of the professorships have 
undergone a change of occupants. What is to be the effect upon 
her fortunes time alone can determine. In relation to the chair of 
materia medica, which became vacant by my own transfer, I have 
no misgivings. The thorough familiarity of our new colleague 
with the subject to be taught, his long and satisfactory service as a 
lecturer upon that subject in a school which has been a nursery of 
teachers, and the zealous energy with which he enters upon the 
duties of his present office, assure us that the department of 
materia medica will not suffer by the change.* How it may be 
with that of the practice, it is not for me even to conjecture. I 
can only assure you that my very utmost shall be done, in every 
way, to satisfy the friends of the school; and, should there be a 
failure, it shall arise from want of capacity, and not from any defi- 
ciency of zeal, effort, or devotion. 

As an institution, I can say proudly, apart from any personal 
concern, that we deserve success. It has been, and continues to 
be our great aim, to maintain medical education at the highest 
point of which it is susceptible among us, and thus to contribute 
at once to the elevation of the character of our beloved profession, 
and to one of the greatest temporal interests of our no less beloved 
country. In that profession, and in that country, I have an abid- 
ing confidence that they will not forsake us, so long as we continue 
to merit their support ; and you yourselves, my young friends, as 
future members of the same profession, to share in its prosperity 
or decay, will sympathize with us in our ardent wishes, and do 
what you can to contribute to the same great, I had almost said, 
holy end. 

* Dr. Joseph Carson, the present professor of materia medica in the 
school. 



LECTURE II. 

DELIVERED OCTOBER 10th, 1851. 



Requisites in the Study of Medicine. 

Accept, gentlemen, my cordial greeting. We have met to- 
gether with a common purpose ; to enter, namely, upon a course 
of duty. My part is to teach you the theory and practice of 
medicine; and I do not know that I can better begin the per- 
formance of the duty than by giving some general precepts to 
guide you in the study. 

1. The first and most important requisite, without which all 
effort must be languid, all appliances partial in effect, and the re- 
sult, to say the least, unsatisfactory, is the possession of a proper 
spirit on the part of the student. If he approach his task cold 
and careless, merely as something he has undertaken and must 
finish, without any just appreciation of its nature and objects, he 
will assuredly fall far short of the attainments, essential to the 
character of an accomplished physician. 

But to become imbued with this spirit, he must have a deep 
sense of the importance of the study in which he is about to en- 
gage, of its great ends, of its fitness for those ends, and of its 
claims upon his conscience as a responsible being. These are 
points, therefore, which I wish to impress on your attention. 

When I tell you that the object of the theory and practice of 

(213) 



214 REQUISITES IN THE STUDY OF MEDICINE. 

medicine, as a department of medical science, is to qualify directly 
for the cure and prevention of disease, in other words, for the 
relief of physical suffering and the preservation of life, I say all 
that is necessary in relation to its ends. Except the salvation of 
the soul, nothing can be more important. But is it really adapted 
to the attainment of these ends ? Is it in fact what it claims to 
be ? There are many who profess to doubt, many who absolutely 
deny its usefulness. But who are these unbelievers? Are they 
men of information, reflection, and sound judgment, men too who 
have had the opportunities for correct decision? If so, their 
opinions must have weight. Let us examine this question. 

They who, by diligent study and long experience, have made 
themselves familiar with the practice of medicine in its principles 
and application, are certainly best fitted to judge correctly on the 
point referred to. Do we find these denying and decrying the im- 
portance of the study? Certainly there are many honest and 
honourable men among them. Do these acknowledge their error, 
and abandon their profession as a system of fraud and deception ? 
On the contrary, do they not in practice and precept maintain the 
validity of its claims ? Do they not devote their whole energies, 
their time, their life, to the performance of its duties, often even 
when mere worldly interest would lead them into other paths ? 

There are undoubtedly medical men who have renounced, and 
now abuse their profession. But who are they ? Some may be 
sincere ; men of unstable minds, whose fancy predominates over 
their judgment, eccentric in their habits of thought, bordering in 
fact upon insanity, if they may not be deemed actually insane. 
But by far the greater proportion are mere calculators, whose 
views of honour and honesty are measured by a pecuniary stand- 
ard, to whom human life, at least the life of others, is of little value 
compared with money, and who, not succeeding to their satisfac- 
tion as regular physicians, and deterred by the fear of the peniten- 
tiary or the halter from illegal crimes, have taken up the trade in 



REQUISITES IN THE STUDY OF MEDICINE. 215 

human life and happiness in the safe form of quackery. Assuredly, 
these are not the men from whom you, my young friends, would be 
disposed to adopt your medical faith. 

As to the opinions of those who have never studied medicine, 
their value is much affected by the consideration that they are 
based in ignorance of the subject. Their sources, too, when care- 
fully examined, will for the most part be found such as completely 
to neutralize their force. 

One of these sources is a feeling of envy or jealousy, which can- 
not tolerate the superiority of medical men in intelligence and 
general esteem, and delights in every opportunity of derogating 
from the profession. 

Another is an ignorant pride of opinion, which glories in an 
asserted independence of all established belief, and is usually ob- 
stinate in proportion as it is erroneous. 

A third is the vain love of notoriety, which enlists under every 
flaunting banner of novelty, if it may only be allowed to act, or to 
suppose that it is acting a conspicuous part. Who does not see 
that this is a ring in the nose, by which many a quack leads his 
throng of male and female advocates ? 

A fourth source, and probably one of the most frequent, is a 
certain restlessness of character, or flightiness of imagination, 
which is ever ready to seize on any new plausibility, and exhibits 
adhesiveness only when strongly committed with the public, or 
with some limited circle. 

But undoubtedly the most frequent source is an honest but weak 
credulity, which yields belief from its own sincerity of nature ; a 
principle of which quacks, swindlers, and impostors of all kinds 
have always taken advantage, and will ever continue to do so, as 
long as imbecility and ignorance shall exist. 

I need not refer, in addition, to the source of unscrupulous self- 
interest, which oversteps all obstacles in the pursuit of its ends, 
sweeps aside from its path honour, and honesty, and truth, and 



210 REQUISITES IN THE STUDY OF MEDICINE. 

self-respect, and the respect of the world, and wades through 
groans, tears, and death, to the sordid object of its desires. We 
shudder at the horrors which have attended the track of the rob- 
ber and the pirate ; of a Pizarro to his gold, of a Robespierre to 
his power; but in what are they worse than the medical pretenders, 
who, without knowledge, or against better knowledge, put life and 
all its attendant blessings at constant hazard ? nay, are they not 
even more respectable, as they venture life against life, while the 
charlatan risks nothing of his own except character in this world, 
and happiness in the next, both of which he has taught himself not 
to value ? 

Such then are the influences which combine to underrate and 
decry the value of regular medical practice. Are they such as 
ought to have weight in your estimation ? Can they stand for a 
moment against the testimony of the great body of educated and 
honest physicians ; against the practical evidence borne by the 
mass of civilized men in confiding their lives to our skill ; in fine, 
against the clearest dictates of common sense, which would cer- 
tainly ascribe more efficacy to the combined medical experience, 
and the aggregate medical reason of all ages, which true medical 
science is, than to the crude theories of a single man, to the wild 
ravings of an insane fancy, or to the mere unsupported pretensions 
and assertions of the pure charlatan ? Indeed, so powerful in this 
respect is the influence of the common sense of mankind, that, even 
with the most bitter opponents of our science, it often happens that, 
in the last fearful crisis, when the passions of this world are silent 
before the threatening presence of death, the aid of the regular phy- 
sician is invoked as the only remaining hope. How often are we 
called to the death-bed of the wretched victim of delusion, to mourn 
over opportunities irretrievably lost ! to witness the last expiring 
glimmer of a life that might perhaps have been rescued, but for 
baseless doubts of regular medicine on the one hand, and equally 
baseless confidence in some miserable quackery on the other ! 



REQUISITES IN THE STUDY OF MEDICINE. 21 T 

You can have no doubt, then, of the inestimable value of this 
branch of medicine. You feel deeply that it is worthy of whatever 
effort or sacrifice may be requisite to make you masters of it. But 
this is not all. The nature of its practical duties is such, that a 
neglect of the means necessary to fit us for their performance is a 
great moral wrong. The artisan, the farmer, the merchant, the 
lawyer may be badly qualified for his duties, without other evil 
than his own failure, or some temporal inconvenience to those who 
trust him. A similar deficiency on the part of the physician may 
and frequently must occasion the loss of life, and thus fix the ever- 
lasting position of the patient. Error with him is often irretrieva- 
ble ; and its consequences may be felt through time, and through 
eternity. Upon your consciences, therefore, is the duty of proper 
preparation obligatory. These considerations should generate in 
you a spirit of zealous devotion to your studies now, and to your 
profession hereafter; a spirit above all sordid views, which shall 
look for its reward not merely to the acquisition of money or fame, 
but to the noble consciousness of powers fitly exercised, to the 
sweet comfort of an approving conscience, and, above all, to the 
smiles of the all-knowing and all-powerful, in whose will are our 
destinies forever. 

2. The next great requisite is due preliminary preparation. It 
would be easy to fill this lecture with proofs of the importance of 
a preparatory education to the medical student, and with details 
of its desirable quality and extent. But such lessons are now out 
of place. You have already entered into the study of medicine. 
Whether duly or unduly prepared, you have already commenced 
the journey ; and it would be useless to recur to the past. I would, 
however, urge on those of you who may be sensible of any deficien- 
cies in this respect, to give a portion of your leisure to the means 
necessary to supply them. Especially would I recommend the study 
of the elements of natural philosophy, and of the grammatical 
structure of the Latin language, the former as essential to correct 



218 REQUISITES IN THE STUDY OF MEDICINE. 

physiological knowledge, the latter to a due appreciation of. medi- 
cal nomenclature. To the commencing student not already familiar 
with these subjects, the devotion to them for a few months of the 
intervals of professional study, too often spent in mere amusement* 
will be of infinite service in facilitating his subsequent progress. 

There is one point connected with this branch of our subject to 
which I would invite your special attention ; I refer to the import- 
ance of a proper habit of study. This is one of the great advan- 
tages of an early education. A well-instructed young man comes 
to the study of medicine with a certain mental training and disci- 
pline, as important in the conquest of its difficulties as military 
training is to the soldier. To those, however, without this advan- 
tage, yet possessing a teachable spirit, a word of counsel may be of 
great value. Do not confound together reading and study. Do not 
suppose that, simply because you have read a book through, you 
know anything of its subject. 

I recollect well, in my student-days, a young man in the same 
office with myself, who used to shame us all by his extraordinary 
diligence. He was incessantly reading medical books. By no 
chance did we ever find him wasting his time in idle amusement, 
in frivolous reading, or in listless indolence. I often felt myself 
spurred on to increased diligence by his apparently ceaseless and 
indefatigable industry. But, at the time of recitation, when we 
were called on to show what we knew, this young man was of the 
whole class the most deficient in his answers, even upon the very 
subjects of which he had just been reading. He seemed to know 
nothing. And what was the cause of this seeming anomaly ? 
It was that he simply read ; he did not study. He allowed his 
eyes to run over the page, catching the meaning if it was obvious, 
letting it pass if otherwise, and using no efforts to make the facts 
and reasoning his own. The result was that he really learned 
little, and allowed what intellectual energy he may naturally have 
possessed to waste for want of exercise. 



REQUISITES IN THE STUDY OF MEDICINE. 219 

I once myself had a pupil, correct, industrious, and extremely 
desirous to learn. At first I was surprised to find that, upon being 
examined on the subject of his studies, he could scarcely answer a 
question. On investigation, I discovered that he was in the habit 
of simply reading, and did not appear to have the conception that 
anything further was requisite. I then made him sensible of the 
difference between reading and study. I told him, in the first 
place, never to pass a sentence without fully understanding its pur- 
port, or trying his best to do so ; if he should find his attention 
flagging, and the words slipping through his mind without leaving 
an impression, to return to them again and again till he had mas- 
tered his own listlessness and the difficulties of the subject together ; 
in the second place, to be quite convinced that he had fixed the 
facts in his memory, and to test the point by mentally repeating, at 
the end of every paragraph, or of every page, what he had learned 
in the course of it; and, lastly, not only to follow the thread of 
every intellectual process, but to examine it carefully, to exercise 
his own judgment upon it, and to satisfy himself, as far as his pres- 
ent lights permitted, of the soundness of the reasoning, and the 
correctness of the conclusion. The advice I gave to him, gentle- 
men, I impressively give to those of you who have not yet formed 
their habits of study. He listened to what I said, became an ex- 
cellent student, and afterwards a highly successful practitioner. 
Should the same happy result follow to any one of those who now 
hear me, this little anecdote will not have been told in vain. 

But, in referring to the subject of preliminary preparation, I had 
in mind not so much the general education antecedent to the study 
of medicine, as that portion of the study of medicine itself which 
ought to precede attention to the theory and practice. The com- 
mencing student is wholly unprepared for efficient application to 
this subject. The child might as well undertake to read without 
having learned his alphabet ; or the youth to practice the higher 
processes of arithmetic ignorant of his multiplication table. You 



220 REQUISITES IN THE STUDY OF MEDICINE. 

must plough the ground, before you can expect profitably to sow 
the seed. How can you possibly understand diseased structure, 
until familiar with the same structure in health ; or diseased func- 
tion, until you know something of normal function ? The studies of 
anatomy and physiology are indispensable prerequisites to that of 
the theory and practice. Not less essential is a knowledge of ma- 
teria medica; for it is obviously impossible to learn how to treat 
disease properly, without an accurate acquaintance with the instru- 
ments employed. Chemistry is another important preliminary study, 
the value, I should say the necessity of which, I wish strongly to 
impress on your convictions ; and the more so as it is but too fre- 
quently underrated. Always important as a branch of medical 
science, it has within a few years become greatly more so, in con- 
sequence of discoveries in the section of organic chemistry, and 
the application of these discoveries to physiology, pathology, and 
therapeutics. They can have no claim to be considered as accom 
plished physicians, who are ignorant of the general principles of 
chemistry, and of such of its details as have a direct bearing upon 
medicine. 

In speaking thus of these preliminary branches, I am using no 
terms of exaggeration, but laying before you the simple truth. I 
would beg of you to neglect none of the studies mentioned, under 
an impression of the greater importance of that which I teach, and 
its stronger claims on your notice. It is true that the theory and 
practice is the great structure, of which the others are only the 
foundation; but without these it can have no useful existence; 
and, where all are essential, it cannot be said that one is really 
more important than another. It would be as easy to fly without 
wings, or to run without legs, as to acquire a competent knowl- 
edge of the theory and practice of medicine, without a previous 
acquaintance with anatomy, physiology, chemistry, and materia 
medica. 

I do not say that you are altogether to avoid the subject of the 



REQUISITES IN THE STUDY OF MEDICINE. 221 

practice, until fully prepared on the preliminary branches. What 
I do mean is, that you are not regularly to commence its study 
until thus prepared. You may, without disadvantage, occasionally 
read in practical works, and listen to practical lectures, at any 
period of your studies, in an incidental way, and as a temporary 
relief from drier subjects ; you may thus even gain a knowledge of 
facts and terms which shall afterwards render the subject some- 
what easier : but you should not allow the regular course of study 
to be materially broken in upon by such excursive indulgences; 
you should take care not to be seduced by the deceptive notion, 
that you are doing anything more than somewhat beneficially re- 
creating yourselves from the real hard work, necessary to make 
you what you are aiming to be. 

3. But let us suppose that the student has thoroughly prepared 
himself for entering on the theory and practice. What course is 
he then to pursue ? First, he should select some general treatise 
on the subject, and study this thoroughly, either under the private 
instruction of a competent teacher, or, what is still better, in con- 
nection with a course of lectures. Such aids are of vast import- 
ance. They point out what is most essential, explain difficulties, 
obviate errors, test knowledge, and incite to diligence and close 
attention. 

Allow me, under this head, to say a few words in relation to the 
course of lectures I propose to deliver. First, you will understand 
that they profess to be merely aids to a system of reading, and not 
substitutes for it. In a number of lectures from 80 to 100, of an 
hour each, it would be utterly impossible, with the utmost com- 
pression, to introduce everything in relation to the practice of 
medicine with which the physician ought to be acquainted. It 
appears to me that the legitimate scope and aim of such a course 
of lectures is, in the first place, as far as possible to give general 
facts or principles, through which the student may himself arrange 
individual facts, and deduce correct conclusions in individual cases ; 



222 REQUISITES IN THE STUDY OF MEDICINE. 

and then, in enumerating, describing, and otherwise treating of spe- 
cial diseases, not to give minute details, filling up and colouring to 
the life every little trait and shade of the picture, but to call atten- 
tion to the important and characteristic points, to fix in the recol- 
lection of the student the landmarks, by a knowledge of which he 
may direct his own steps, through the intricacies of the subject. 
Upon this plan, a course of the extent referred to may be made to 
embrace the whole circle of diseases belonging properly to this de- 
partment. It is the plan which I propose to follow in conducting 
the ensuing course. 

I scarcely need tell you that another principle of my plan of 
teaching is to be as far as practicable demonstrative ; to illustrate 
to the eye by diagrams, pictures, models, wet preparations, instru- 
ments, etc., whatever is susceptible of such illustration ; and I ap- 
peal to those who may have attended my previous course, whether 
there is not in our subject a vast deal capable of being thus treated, 
and whether, on a great many points, much more vivid impressions 
may not be made by these auxiliary means than by words alone. 

I would repeat, that the prominent objects at which I aim, in 
conducting my course of lectures on the practice, is to render them 
comprehensive and illustrative ; and it is in these respects, if in 
any, that they may claim to be peculiar. 

In following the course, your plan will be to recollect as far as 
possible the facts, processes of thought, and deductions; if you 
have great facility in writing, to take such notes as may tend to 
aid your memory in recalling the more important points; and 
then, in the intervals of the lectures, to read upon the subject in 
the text-books. 

I have always considered a system of examinations, in connec- 
tion with courses of lectures, as highly important. However great 
may be the zeal of the student, the consciousness that his pro- 
ficiency is about to be put to the test, will increase his powers of 
attention, and, I may go so far as to say, even his will to attend. 



REQUISITES IN THE STUDY OF MEDICINE. 223 

He thus absolutely learns more from the lectures themselves than 
he would do without such a stimulus. Nor is this all. The promi- 
nent facts being presented a second time to his notice, if recol- 
lected, will be still more firmly fixed in his memory, and, if not 
recollected, will be so impressed on him that he will afterwards be 
much less liable to forget them. Besides, misunderstandings of 
what was said in the lectures are by this mode of rehearsal cor- 
rected; and difficulties, not sufficiently explained or accurately 
comprehended, may now often be rendered perfectly plain to the 
understanding. These are truths which I have had innumerable 
opportunities to verify. I have been in the habit of conducting 
medical examinations now for more than forty years, and consider 
them in the highest degree valuable in a course of medical tuition. 

4. But now let us suppose that you have thoroughly studied a 
systematic treatise or treatises on the practice of medicine, and 
have derived all the advantages possible from attendance upon 
courses of lectures on the subject. You are not on this account to 
consider your studies as completed. You have in fact only laid 
the foundation, and erected the frame-work of your future knowl- 
edge. You have yet to do the filling up and finishing of the 
structure. For this purpose you are now to leave the general 
treatise, and turn your attention to monographs on special dis- 
eases, or treatises on certain sets of diseases having some common 
bond of union. These you are prepared by this time thoroughly 
to understand, and in great measure to appreciate. Not only will 
you thus acquire a greater mass of facts, and become conversant 
with different views, but will learn to think for yourselves. You 
will escape the dangers of an indolent reliance upon the thinking 
of other people, of pinning your faith to the sleeve of any man, of 
swearing by the words of any master. 

It is believed by some that the present mode of teaching, by a 
system of reading and examinations, has the injurious tendency to 
stifle all independence or originality of thought, to make the stu- 



224 REQUISITES IN THE STUDY OF MEDICINE. 

dent familiar with a certain routine of facts and formulas, and to 
give him the impression that nothing more is needful ; in fine, to 
make of him a mere instrument for carrying into practice in com- 
munities certain cut and dried notions that have been packed into 
him — a kind of medical sowing machine, that shall scatter its 
seeds, in the same proportion, over all sorts of ground, in all states 
of preparation. It must be admitted that such might be its influ- 
ence, if instruction were carried no further. But we are not to 
suppose that the student is to stop here; and, for fear that he 
should stop here, we are assuredly not justified in advising him 
not to proceed thus far. As well might you avoid teaching a 
child the grammar of a language, for fear that he might ever after- 
wards speak and write with the stiff formality of rules. No ! This 
exact mode of instruction is of vast importance by giving accuracy 
and precision to knowledge and thought. "Without it, trusting 
merely to himself, the student would be apt to be inaccurate in 
attainment, loose and discursive in his reading and thinking, cull- 
ing the flowers only as he proceeded, indulging the imagination 
rather than disciplining the reason, and withal acquiring a self- 
confidence and self-reliance, very proper and very useful when 
based on correct knowledge and mental discipline, but a curse to 
himself and those who trust him, when connected, as they too often 
are, with real ignorance and inexperience. 

Neither plan, then, is exclusively right ; neither that of systema- 
tic study under constant superintendence, nor that of discursive 
reading without experienced guidance. The two should be com- 
bined, and the former should always precede the latter. Accuracy 
and precision may thus be attained, and a mechanical routine 
avoided. 

As to the particular special "treatises that you should read, or 
the order in which they may be read, no very precise rule is neces- 
sary. The choice may very well be left to the judgment and taste of 
the previously instructed student. It will certainly be more or less 



REQUISITES IN THE STUDY OF MEDICINE. 225 

influenced by his opportunities, his predilection for one or another 
specialty in our science, and the character of the disease or dis- 
eases which may come under his notice, and which he may desire 
to investigate. And this leads me to another, and the last step in 
the education of the medical practitioner. 

5. You have heard much of clinical instruction; and you can 
scarcely have heard its importance overstated. To show disease 
by the bed-side is the true mode of demonstrating it. Until you 
come to the practice of your profession, you can with difficulty 
conceive how essential the personal observation of disease is to the 
proper understanding of it, and how little the notions often formed 
from reading or oral instruction correspond with the reality. The 
young physician who engages in the business of his profession, 
without this previous preparation, finds himself at a loss in recog- 
nizing the most common diseases; and it is only after frequent 
trials, and not unfrequent blunders, that light at last breaks upon 
him, and he begins to learn to diagnosticate in practice as well as 
out of books. To recognize and treat a complaint well, without 
ever having seen it, or anything like it, would be as difficult as to 
make a coat or a shoe, after having been taught by description the 
various steps of the process, without having seen it put into 
practice. 

From the very commencement of your studies, you should em- 
brace every occasion to become practically familiar with disease. 
Like the botanical student who, in all his excursions, whether of 
pleasure or business, seizes eagerly on every unknown plant along 
his path, and plucks it for examination; so should you be ever on 
the watch for the objects of your own pursuit, and, whether in 
town or country, by day or night, in the search of enjoyment or 
the performance of duty, catch each fleeting opportunity, and 
gather as much as you can of the good which it offers. Of course, 
your first impressions will be vague and unsatisfactory; but you 
will be acquiring a practical knowledge of the pulse, of the various 

15 



226 REQUISITES IN THE STUDY OF MEDICINE. 

appearances of the tongue, of the colour, temperature, and other 
qualities of the surface, of the expression of the face, etc., which 
will be of great service in your subsequent studies, as well as in 
your clinical observations. You should also explore the sounds of 
the chest and the heart, and practice percussion and auscultation 
upon the well and the sick, the young and the old ; and, though I 
would not advise you, in all your social intercourse, to be watching 
your friends of either sex thus professionally — to slide your fingers 
from the palm to the pulse at every greeting, to count the respi- 
rations when you ought to be listening to the words, or to think 
of the heart technically whenever you may happen to feel or to 
witness its throbbings — yet there are frequent occasions when all 
this may be done, with very great propriety, and no less profit. 
To procure such opportunities, you should be ever ready to aid in 
the performance of the offices, so often called for in the care of 
the sick ; to sit up with them at night, to prepare and adminis- 
ter their medicines, to make the various external applications, to 
arrange their positions, to bleed, leech, cup; in a word, to do 
everything that may tend to familiarize you with the duties, which, 
if you do not actually have to perform in future, you will certainly 
have frequent occasion to direct and superintend. 

It is especially, however, w T hile studying the practice, that you 
should seek for opportunities of observing actual disease in all its 
relations. Those of you who pursue your studies in rural situa- 
tions have a fine field open to you in the practice of your pre- 
ceptors, whom you may often materially aid, while benefitting 
yourselves, by an occasional visit to his patients when he is over- 
burdened, and by rendering those numerous offices about the sick 
which nurses cannot always be found competent to perform, yet 
the due performance of which is scarcely less essential to a favour- 
able issue than the prescription of the physician himself. Allow 
me, in this place, to offer a hint which may not be useless in refer- 
ence to your ultimate interests. When acting as nurses, you 



REQUISITES IN THE STUDY OF MEDICINE. 227 

should endeavour to sink self in the office, to make the patient the 
main if not exclusive object of concern, and scrupulously to avoid 
all those levities, which, however excusable in youth under other 
circumstances, are certainly out of place in the presence of human 
suffering, of danger, perhaps of death. Appropriate deportment 
under such circumstances, not only the proper performance of pro- 
fessional offices, but a becoming sympathy with the patient and his 
friends, will, you may be assured, be remembered to your advan- 
tage ; while a contrary course may leave an unfavourable impres- 
sion, which the whole future life may not entirely efface. I know 
well that youth cannot make the experience of age its own ; but, 
when the proper disposition exists, when the soil of the heart is 
good, a word of admonition duly planted may take root, and spring 
up to ultimate profit. 

For those who study in large towns, abundant clinical opportu- 
nities are usually afforded in hospitals, dispensaries, and other 
public institutions, which a student would be quite unpardonable 
in wholly neglecting, if he have any view ultimately of taking upon 
himself the care of the sick. Undoubtedly, the most efficient 
method is to visit the sick bed along with a competent instructor, 
and there thoroughly investigate the case. To the zealous more 
or fewer of such opportunities are generally presented. It is true 
they must be sought. You must put yourselves in the way of 
catching the fleeting chances as they offer. They will certainly 
not follow and hunt you up in your private places of abode or of 
resort. But recollect, gentlemen, that years hence, you will often 
bless the perseverance and self-denial which you may now exercise 
in this sphere of duty. 

Next in advantage to these private bed-side studies is attend- 
ance upon the clinical instruction, provided in hospitals for classes 
of students. When large numbers of young men are to be taught 
at the same time, it is obviously impossible that they should be 
advantageously taken from bed to bed in the wards. I have tried 



228 REQUISITES IN THE STUDY OF MEDICINE. 

this plan, and know it from experience to be productive of little 
good to the pupil, while it is often greatly oppressive to the 
patient. The confusion, the noise from shuffling feet, the impos- 
sibility of hearing in the outskirts of the crowd what may be said 
by the prescriber, and the want of due access to the bed, often 
counteract and neutralize all the good produced. The proper 
method is to collect the audience in a suitable apartment, and to 
bring the patient before them at a point whence he can be seen by 
all, and whence the lecturer, stationed at his side, can be heard by 
all. By this plan the learner is enabled to bring all the requisite 
faculties, except only the sense of touch, to bear upon the case 
presented. The teacher has the opportunity to demonstrate the 
disease, with the certainty that at least most of what he points out 
will be seen, and that all that he may say will be heard. He is, 
moreover, enabled to make a selection of cases from the wards, to 
bring forward together those which are analogous, or have im- 
portant mutual relations, and thus to present his facts and reflec- 
tions to the student in a succession, which will greatly increase 
their impressiveness, and cause them to be more easily recalled by 
the memory when needed. Many of you are aware that this is the 
plan adopted in the Pennsylvania Hospital, the only one in fact at 
all applicable to the circumstances in which that institution is 
placed, in relation to medical instruction, in the winter season. 

I need not urge on you the importance of attending the clini- 
cal instruction thus offered. In ours, as in many other medical 
schools, such attendance is made obligatory on all candidates for 
the degree. Wherever practicable, it is I believe considered, both 
in this country and Europe, as an essential part of medical educa- 
tion. In a rearrangement of the fees which took place some years 
since in the medical department of the University, the price of the 
Hospital ticket, over which our school has no control, was de- 
ducted from the amount of the graduation fee, so that, though paid 
by the student, it should in reality cost him nothing. I revive the 



REQUISITES IN THE STUDY OF MEDICINE. 229 

remembrance of this fact, in order to show the estimation in which 
clinical instruction is held by those who regulate the concerns of 
our institution. Indeed, the advantages of this most efficient 
method of demonstrating disease, whether attained through hospi- 
tals, dispensaries, or in the walks of private practice, can scarcely 
be overrated ; and the day, I hope, will come, when they shall be 
so clear not only to the profession but to the public generally, that 
all will unite in throwing open as widely as possible to the students 
of medicine the portals of every avenue that can lead to their 
attainment. 

With these observations I close the advice I had to offer you. 
I am well aware that to many of you, much of what has been said 
is quite superfluous ; but if they by whom the paths of medical 
study have but just been entered, and who may be still somewhat 
embarrassed by the novelty of their position, should derive any 
advantage from them, my purpose will have been fully answered. 
Even those of you who least need the lessons will, I know, excuse 
them, when you reflect that they proceed from one ojd enough to 
be your father, and whose experience in medical teaching began, 
before the greater number of those who now hear me had seen the 
light of this world. I have endeavoured to make them plain and 
simple, aiming at no ambitious ornament, but solely to be under- 
stood, and to be impressive. 

I once more, gentlemen, welcome you to these halls, and on my 
own part, as well as on that of my colleagues, assure you that no 
pains of ours shall be spared, in promoting the great purpose for 
which you have come, and in rendering you whatever aid may be 
necessary to make you all that your best friends could wish. 



LECTURE III. 



DELIVERED OCTOBER 14th, 1858. 



Character and Objects of the Medical Profession. 

Accept, gentlemen, my cordial greetings. Allow me also thus 
early to bespeak your friendly sentiments, in return for those which 
I offer you. Reciprocal kindliness of feeling will greatly lighten 
the burden of our coming duties ; and I am not without the hope, 
that the labour which might otherwise be looked upon as a task, 
may become a real pleasure, under the cheering influence of mutual 
good-will, and hearty co-operation. 

I am to be your guide, my young friends, through the intricacies 
of practical medicine, which now lies before you like a seeming 
wilderness. I hope to be able not only to make your path plain, 
but to show you that what, to the inexperienced eye, may seem a 
tangled labyrinth, is in fact a wisely planned system of harmonious 
and beneficent order. I hope, too, though your journey will be 
necessarily toilsome, to lead you into many grateful and refreshing 
scenes ; through grassy glades, by cool rivulets, beneath the shadow 
of magnificent groves, where the sense of weariness or fatigue may 
be lost in that of the beautiful or grand, and the sweat of your 
brows be fanned away by the sweet breath of nature. 

Yet, before we enter together this scene of mingled labour and 
enjoyment, I have a duty to perform. I must tell you what lies 
(230) 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 231 

beyond it. I must endeavour to give you some knowledge of that 
wider field of practical duty, to which the course of study you are 
about to enter is merely preliminary. But it is not my intention 
to represent to you specially either its attractive or repulsive quali- 
ties. Having already enlisted under the banner of medicine, you 
need no allurements to entice you onward, and are not likely to 
be alarmed into desertion by any picture of the possible evils to be 
encountered. My aim is only so to place before you the character 
and objects of your future profession as to enable you to appreciate 
its requisitions, and to stimulate you to every needful effort. 

1. Prominent above all other points is the consideration, that 
the medical profession is not to be regarded as a mere business ; 
as the means of securing a livelihood, or accumulating a fortune ; 
as an instrument for the attainment of any object whatever of a 
purely selfish character. Reflect for a moment on the great ends 
which it proposes ; the relief of human suffering, and the preserva- 
tion of human life. To live, and to be exempt from bodily pain 
are, upon the whole, the two greatest earthly blessings of man. It 
is true that they are often put at risk in the pursuit of other objects. 
In the spirit of the gambler, we recklessly stake them in the vast 
games of the passions ; in the spirit of the martyr, we sometimes 
offer them up at the shrine of duty; but, in the former case, the 
loss of the game is despair ; in the latter there is simply an ex- 
change of a temporary for an endless blessing, of life and its com- 
forts here, for an eternity of happiness hereafter. What are all the 
good things of this world without health to enjoy them ? and what 
boots it, if we gain wealth and power, or attain our immediate ends 
in the pursuit of any other secular object, and at the same time 
lose our own lives, upon the continuance of which hangs all the 
pleasure of success ? What is the highest cruelty of which man can 
be guilty, the characteristic in which he approaches nearest to the 
beast of prey, if it be not the infliction of bodily torture ? Why is 
it that a cold shudder creeps through us at the very name of the 



232 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

inquisition? What gives to the North American Indian the atro- 
cious pre-eminence among savages, which the holy brotherhood 
holds among civilized men ? Is it not that the slow anguish of the 
stake is the highest conceivable degree of human suffering? Say 
what we will of mental torture, how few there are who are willing 
to escape it, at the cost of even a comparatively brief torture of the 
flesh! 

If, then, bodily ailment and the loss of life are the greatest of 
worldly evils, how noble must be that pursuit whose purpose is to 
obviate them ! How great the responsibility of those who under- 
take its duties ! This is the light in which our profession should 
be habitually viewed by all its votaries. In entering it, we assume 
an obligation to devote ourselves to its high functions. This should 
be the prominent feeling of every medical student and practitioner. 
How powerful the stimulus thus offered, in every well-constituted 
mind, to industry and zeal in the work of preparation ! With the 
medical student, it is not a question, as with the mere worldly 
neophyte, whether he shall personally gain or lose in proportion 
to his industry or negligence. Were this the only consideration, 
he might often, under strong temptation, reconcile himself to inat- 
tention and idleness, upon the ground that his conduct is purely a 
matter of expediency ; that, if he choose, for present gratification, 
to sacrifice a portion of future good, no one has a right to com- 
plain, as no one but himself can be affected. It is true that, even 
in reference to sordid interests alone, this reasoning would be un- 
sound. But it is not without some plausibility, and might not be 
without effect. But in the higher view here taken of the scope of 
the profession, which beyond all controversy is the just one, such 
an excuse could not be offered to the most obtuse conscience. The 
student, habitually keeping it before his eyes, could never give way 
to the temptation of idleness, or distracting indulgence, without a 
consciousness of neglected duty. He would feel, when yielding 
unduly to enticement, that he was inflicting evil on others; that, in 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 233 

failing to use all diligence in qualifying himself for bis profession, 
he was, in the same proportion, doing injury to his prospective 
patients, repaying their good-will and confidence with suffering 
and perhaps death, and laying up remorse for his own future. 

Fix then indelibly in your minds this high conception of your 
future office, and let it mingle with and pervade all your pro- 
fessional thoughts. Consider yourselves not as traffickers in the 
pursuit of gain ; not even as mere aspirants for honourable dis- 
tinction; but as men destined by Providence for the performance 
of a great duty ; a kind of priesthood, set apart and anointed for 
a peculiar and sacred function, to which belong, in a considerable 
degree, the issues of happiness and misery, of life and death, and 
in which unfaithfulness, either in promise or performance, is an 
offence not against man only, but the Most High. 

The habitual cherishing of such a sentiment will have other im- 
portant effects, besides those of encouraging diligence in the pursuit 
of professional knowledge. It will have an elevating and ennobling 
influence upon your character. One lofty sentiment, habitually en- 
tertained, acts like a ferment, leavening, in a greater or less degree, 
the whole soul into its own nature. There is happily a contagion 
of good as well as of evil. Simply realize the fact, that, by enter- 
ing the medical profession, you bind yourselves to devote your best 
energies to the good of your fellow-men, so far as life and health 
are concerned ; and the simple consciousness will raise you above 
what is sordid or grovelling. You will feel yourselves invested with 
a moral dignity and self-respect, as with a robe of ermine, which will 
cause you sedulously to shun every soiling contact. 

Picture to yourselves a man who becomes a physician from 
purely sordid motives. In the first place, he is probably insuffi- 
ciently prepared, because he has been without sufficient inducement 
to the requisite exertion. In the second place, as his wish is not 
so much to cure disease as to make money, the former object will 
yield to the latter, when the two are incompatible. He is likely, 



234 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

therefore, at once, to be an unskilful practitioner, and not to employ- 
to the best advantage, therapeutically, the knowledge he may pos- 
sess. He looks upon his unfortunate patient simply as a customer. 
Allow him to be at first so far an honest man as to be disposed to 
sell the best that he may have at a fair price. This disposition 
cannot long continue. The tendencies of his mercantile position 
will always be, to make as much money with as little expenditure 
of time and trouble as possible. The resistance of evil requires 
the constant support of strong principle, with the careful avoid- 
ance of all seductive influences. Among the petitions that we are 
directed in Holy Writ to offer to our Father who is in Heaven, is 
that we may not be led into temptation. A physician with no 
other than sordid motives is unceasingly and voluntarily exposing 
himself to influences which he is thus taught to shun. The prayer 
against temptation can, under such circumstances, be of no possible 
avail. It would be as though we should beseech to be saved from 
poison, while of our own accord swallowing arsenic. The sordid 
tendencies would undoubtedly predominate, and, unless in a mind 
extraordinarily well constituted by nature, would be apt in the end 
to gain unresisted sway. 

Let us trace the probable course of the mere trafficking doctor. 
It differs somewhat under different circumstances; but on the 
whole is inevitably downward. Suppose him to have a fair start, 
in an unoccupied field, and without competition. At first, if not 
already corrupt, he may aim to practise fairly, giving to each case 
its due amount of attention, and demanding only a just remunera- 
tion. But he soon begns to find, or at least to imagine, that he is 
not making the most of his opportunities. He learns that he may 
gain more, with less cost of time and labour. His visits to the 
patients who can pay little gradually become fewer ; to those who 
can pay well gradually more frequent ; for he is paid by the visit ; 
and he begins to think that no one is entitled to attention he can- 
not pay for, a whit better than to a pair of shoes or a pound of 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 235 

bread below cost. As it happens, this is lucky for the poor man 
affected with a spontaneously curable, or easily treated disease ; for 
he gets well with little medicine and at a small expense. But woe 
to him if seriously ill, and in need of incessant and careful atten- 
tion. Woe, too, to the rich man in pocket and in health. His is 
a case to be cherished. He receives visits, it is true, in abundance, 
and doses without number; but there is no corresponding amend- 
ment. He may at length get well ; for nature often cures in spite 
of the doctor; and, besides, the conscience is not yet absolutely 
hardened to murder; and even interest requires that the sheep 
already fleeced should be kept for another shearing. Some atten- 
tion, moreover, is necessary to reputation; and the patient and his 
friends must not be scared off by suspicions, either of deficient skill, 
or of foul play. The duration of the case, therefore, so far as it 
depends on the doctor, is a matter of somewhat complex calcula- 
tion. On the one side are the dollars ; on the other, some remains 
of conscience, a prudent regard for reputation and future oppor- 
tunities, and, perhaps, a sickly season. Professional duty and the 
welfare of the patient are not taken into account. 

But let us suppose that competition springs up, or has existed 
from the first. He has now a double game to play. Gold must 
be won, and the rival undermined at the same time. There may, 
under these circumstances, be more caution in practising tricks of 
trade ; for a watchful and knowing eye is upon his movements, and 
a fair seeming is essential to success. Here the sordid spirit shows 
itself in endeavours to depreciate the rival by disadvantageous 
comparisons, false insinuations, or even direct falsehood. Offence 
is thus given to the medical brother, however correct and high- 
minded he may be ; and hence unseemly disputes, which disgrace 
the individuals concerned, one or both, and injure the profession 
generally in public esteem. 

Perhaps, instead of regular competition, some variety of quack- 
ery comes upon the stage; and the public mind is thrown into 



23G CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

excitement by the novelty, or th3 flaring pretensions of the new 
practice or doctrine. Our doctor, if quite lost to all principle and 
self-respect, and surrendered, body and soul, to mammon, is now 
apt to set his sail to the popular breeze, and to meet the new rival 
with his own weapons. Perhaps he proclaims himself a convert, 
and professes to practise on the novel plan. Perhaps he goes 
only half way, and, medical demagogue as he is, declares his sub- 
mission to the will of the people, and engages to cure them in 
whatever way they may deem best, whether by homoeopathic glob- 
ules, by sweating and red pepper, by cold water, or in the old ac- 
customed method. 

There is yet one further step in the ignoble descent. His 
cupidity is excited by the reported success of some renowned 
advertising doctor. He hears of this or that pill-vender, or nos- 
trum-monger, as having accumulated boundless wealth, and living 
in corresponding magnificence. Visions of similar prosperity pre- 
sent themselves to his inflamed imagination. He is aware that a 
gulf of infamy lies between him and the realization of the splendid 
picture. He nevertheless takes the last desperate leap into the 
slough before him, and either sinks dishonoured, or rises up, clutch- 
ing the coveted prize, but covered all over with the filth of degra- 
dation, which, though he may endeavour to conceal it with the 
splendour of his fortunes, no subsequent cleansing can remove, 
save only the washing of regeneration. 

I have thus endeavoured to sketch the gradual descent to which 
they are liable, who, in the practice of medicine, start with the sole 
object of pecuniary advantage. You may think that I have spoken 
strongly. But consider simply the consequences of deviation from 
the path of rectitude in medicine. Recollect that human life is at 
stake. The world and even the profession are apt to look upon 
this thing too lightly. They often speak of success or failure, as 
of the same results in other pursuits, and make a jest of quackery 
as they would laugh at a juggler. But this conversion of medicine 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 231 

into a trade is no laughable matter. Language, in my estimation, 
is scarcely strong enough to express its intense criminality. Life 
is put at hazard, not unfrequently sacrificed for a little money. 
Let me not be told that there is no murderous intent. There is at 
least full knowledge that death may ensue ; and, if it take place, in 
what is the manslayer less guilty than if it had been purposed ? It 
may be said, in extenuation, that the patient is not so often posi- 
tively killed by the treatment, as allowed to die from the omission 
of proper means of safety. There is scarcely the difference of a 
hair's breadth between the cases. In what respect is the prac- 
titioner, who neglects means which he may believe to be necessary, 
because in opposition to his supposed interest, less criminal than 
another, who, under similar influences, administers a medicine, 
knowing that it may prove deadly ? Both are equally guilty ; and 
neither, in my conception, better than the robber who kills you for 
your purse, or the assassin who deals the fatal blow for a fee. Nay, 
the latter, if not less guilty, are less mean-spirited ; for they place 
their own lives at hazard, while the medical homicide cowardly 
sneaks to the same end under the safe cover of the law. You may 
understand how, with these views, I can feel only disgust or abhor- 
rence for such unprincipled men, however apparently prosperous 
their fortunes, and under whatever hypocritical disguise they may 
conceal their moral deformity. 

The proportion of those who, having been regularly educated as 
physicians, sink to this depth of depravity, is happily very small; 
but such is the tendency in every instance, in which the true aim 
and scope of the profession are lost sight of in eagerness for gain ; 
and, though many may be arrested in various stages of the descent, 
no one is exempt from the danger of utter degradation who has 
once entered the downward path. 

Even men who may succeed to their heart's content, in the 
attainment of practice and its pecuniary rewards, find that, after 
all, this is but poor compensation for their necessary labours and 



238 CHARACTER AND OBJECTS OF THE MEDTCAL PROFESSION. 

privations. Worn by days of labour and sleepless nights; inter- 
rupted at meals, or in the rare enjoyment of social pleasures ; 
breasting the midnight storms of winter, or sweltering in summer's 
noonday sun; fretted by conflicting claims, jarring professional 
views, the reproaches of disappointment or discontent, the mis- 
representations of envy, malice, or opposing interests; can the 
medical practitioner, thus suffering from bodily and mental dis- 
comforts, find adequate compensation in the mere swelling of his 
hoard of dollars ? No, gentlemen ! Were this his only source of 
comfort, he would be wretched in the midst of accumulation. 
Something more is necessary to yield him an adequate recom- 
pense. This he finds, and can find only, in the consciousness that 
he is fulfilling a high duty, and is thus laying up treasures where 
neither moth nor rust corrupts. 

But, while thus endeavouring to bring before you the unspeak- 
able evils of a purely mercenary spirit in the practice of medicine, 
it has been far from my intention to lead you to undervalue the 
claims of the physician to a just remuneration. As in other avoca- 
tions, so also in medicine, the practitioner must live by his labour. 
Being, from the necessities of his position, the associate of men in 
the highest walks of life, he must earn through his profession the 
means of supporting a conformable style of living. The capital 
expended in qualifying himself for his pursuit must be repaid. He 
is, moreover, justly entitled to such a professional income as may 
enable him, after a successful career, when his mental and bodily 
powers begin to fail, to withdraw from active duty, not only with 
a competence for his old age, but with a suitable provision for his 
family. His compensation, therefore, must be on a liberal scale* 
Experience determines what is necessary on the basis of calculation 
just stated ; and in all communities prices arrange themselves as a 
necessary result of existing circumstances. Two evils are to be 
avoided, both generally flowing from the sordid views against which 
I have endeavoured to guard you, and both having a debasing in- 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 239 

fluence on the profession. One is that of underselling, by which a 
mercenary practitioner hopes to prosper at the expense of his pro- 
fessional neighbours. This is justly regarded by the mass of medical 
men as mean and discreditable ; and he who notoriously practises 
on this principle loses more in the good opinion of his fellows, and 
of high-minded men generally, than he can possibly gain in a pecu- 
niary point of view. The other evil is that of extortionate charg- 
ing, by which a medical man brings discredit both on himself and 
the profession, and, in fact, though he may gain for the present, is 
apt to be a loser in the end. To avoid these extremes, it is cus- 
tomary for medical communities to determine the proper compen- 
sation for professional service in their several neighbourhoods, and 
thus to fix a standard, any material deviation from which would be 
regarded as discreditable. But great latitude is necessarily allowed, 
in consequence of the varying circumstances of the sick ; and, when- 
ever the regular charge would be oppressive, it is not only admis- 
sible, but even right, and I think, morally obligatory on the prac- 
titioner, to make corresponding allowances. Indeed, a necessary 
consequence of the view of professional duty that I have presented, 
is that we must, if in our power, even attend the sick gratuitously, 
when they are without the ability to compensate us, and no other 
means of relief are at their command. If the practice of medicine 
were a mere traffic, these rules would not be necessary. Like other 
trades, it would prosper most when quite unrestricted. The simple 
rule then would be that every physician should make as much out 
of his opportunities as possible ; and that his services should never 
be called into requisition, when they cannot be paid for. In our 
view, on the contrary, his services should be rendered whenever a 
necessity for them may exist, and the compensation be made a 
secondary consideration. 

The same may be said of good-will, reputation, distinction, fame, 
as the reward of medical service. These are certainly allowable 
and even praiseworthy motives of action. They may be looked on 



240 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

as of a higher character than mere gain. The student who pur- 
sues them through a laborious course of preparation, and the prac- 
titioner who wins them by continued efforts after higher qualifica- 
tion, and the diligent performance of his practical functions, 
assuredly stand upon higher ground than he who aims only at the 
dollar. But they should ever be regarded as secondary, and sub- 
ordinate to the great principle of duty. 

If without irreverence we may quote the Scripture declaration, 
"seek first the kingdom of God and his righteousness, and all 
these things shall be added unto you," I would say that, what this 
divine injunction is, in its religious bearing, is the analogous in- 
junction in our professional relations; seek first to perform your 
duty to the sick, and all else that is needful or desirable, whether 
pecuniary reward, the affectionate regard of others, or general 
reputation, will follow as an almost necessary consequence. 

2. We have hitherto been considering the profession in relation 
to its ends. But there are other points of view, in which it must 
be regarded by those who desire to fulfil all its requisitions, and to 
bring themselves into exact conformity with its character. 

It is, you know, universally ranked among the learned profes- 
sions. Some acquaintance with the natural and physical sciences 
is essential to the physician as a mere practitioner; but more than 
this is expected. Like other men of liberal education, he is sup- 
posed to know something of the past ; to be more or less conver- 
sant with historical deeds and characters, with opinions which 
have influenced the course of human events, with the great pro- 
ductions of genius in literature, philosophy, and the arts. He 
must, moreover, not be quite ignorant of the existing condition of 
the world ; of the races of men and their distribution ; the divi- 
sions of the earth and its products ; international relations ; the 
principles of government; the state of learning and science; the 
great interests of agriculture, manufactures, and commerce. These 
are subjects to which every educated gentleman is presumed to 



CHARACTER, AND OBJECTS OF THE MEDICAL PROFESSION. 241 

have paid more or less attention, and gross ignorance of which 
would, as a general rule, be considered as evidence of neglected 
intellectual culture, and consequent incapacity for duties, which, 
like those of practical medicine, peculiarly call for the exercise of 
intellect. 

It must be admitted that the vulgar often estimate a physician's 
professional abilities by a different standard. They are apt to 
consider medical qualifications as a gift. These, they often think, 
come by nature, like supernumerary toes or fingers. A natural 
bonesetter takes precedence, in their estimation, of a Dupuytren, 
Sir Astley Cooper, or Dr. Physick. A seventh son is a born 
doctor ; and the seventh son of a seventh son, is a very miracle in 
the art of healing. Now, as the vulgar may be found among the 
rich as well as the poor, a practitioner who can inspire such a 
belief of his extraordinary gifts, may possibly attain a profitable 
practice, especially if possessed of that sort of talent which makes 
a successful juggler or swindler, namely, the talent of humbug. 
But he could scarcely pass muster with the thinking and intelli- 
gent portion of the community. These, being quite ignorant of 
medicine, can judge of him only by the attainments he may possess 
in common with themselves. If they find him generally well in- 
formed, and of sound judgment in things they understand, and at 
the same time have reason to believe that he has been industrious 
as a professional student, they will give him credit for correspond- 
ing proficiency in medical knowledge and skill, and be disposed to 
seek his aid when the occasion offers. You perceive, then, that 
the physician, possessed of general information, stands a better 
chance of professional success than the mere pretender, or even 
than one tolerably qualified as a practitioner, but ignorant in other 
respects; and, at all events, should he fail to gain a greater 
amount of practice, he would certainly take a much higher posi- 
tion in the general esteem of the community. 

Especially is it important that he should not be ignorant upon 

16 



242 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

the subjects connected with his professional pursuits, though they 
may have no direct bearing upon the treatment of disease. Thus, 
he should be informed as to the sources of drugs, the origin and 
spread of diseases, and the history of the progress of medicine. 
Independently of his own personal satisfaction, and his own self- 
respect, the possession of this sort of knowledge will have a special 
bearing on the opinion formed of him by others. Many persons, 
ignorant of medicine professionally, have considerable information 
on such subjects, and are quite capable of detecting the want of it 
in the physician. It may be readily conceived that they would not 
feel themselves bound to silence; and that an estimate would be 
formed by the community of professional abilities in accordance 
with the ignorance displayed. 

Suppose, for example, that a young medical pretender should 
inform his hearers, perhaps in answer to testing questions, that 
Peruvian bark is produced in Labrador, and Iceland moss on the 
Andes ; that Jamaica pepper grows in the East Indies, and Ceylon 
cinnamon in the West; that Galen discovered the anti-variolous 
influence of vaccination, and Hippocrates was highly skilled in 
auscultation and percussion ; that yellow fever is a native of Alex- 
andria in Egypt, and the plague of New Orleans; and that epi- 
demic cholera originated somewhere in Kentucky, or perhaps in 
California ; what do you suppose would be the opinion formed of 
his real professional attainments? And yet I have often known 
answers as absurd, given by candidates for medical honours. 

You will, then, agree with me in believing that more or less 
general knowledge is essential to the physician, and will direct 
your studies accordingly, not now only, but during the whole 
course of your professional life. I do not here refer to the pre- 
liminary studies requisite in anticipation of the professional. This 
is an extremely important theme ; but it does not come within the 
scope of the present address. I may, however, be permitted, so 
far to allude to it, as to suggest to those among you, if there be 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 243 

such, whose early opportunities have not been favourable, the pro- 
priety of endeavouring, henceforth, as far as may be in their 
power, to supply the deficiency by additional labour and diligence. 
But I have as yet offered you only the humblest motives for the 
cultivation of general knowledge, in connection with that strictly 
professional. I have appealed only to your hopes of success in 
obtaining business. But there are inducements of a higher nature. 
An ampler development is thus given to your intellectual powers; 
a wider scope for the exercise of thought, and the cultivation of all 
your better feelings ; a deeper insight into the springs of human 
action, and, as a result of all these advantages, a more powerful 
influence over yourselves, and over the thoughts, convictions, 
actions, and characters of others. You are thus elevated in the 
scale of civilization, are rendered more useful members of the com- 
munity in which you live, and add to the resources of pure medi- 
cine, in the treatment of disease, others altogether unknown to the 
uncultivated man. Something more than the knowledge of dis- 
ease and of medicines is necessary to constitute the greatest skill 
in the healing art. In diagnostic investigations it is often im- 
portant to enter deeply into the mental constitution of the patient, 
in order to estimate the nature and extent of the moral influences 
that may have been concerned in producing, or may continue to 
operate in keeping up the complaint. Nor is it less important, in 
a therapeutical relation, to have the power of applying such influ- 
ences to the modification of disease, either directly, or through the 
co-operation of the mind of the patient with the remedial agencies 
employed. How can all this be done by a physician without men- 
tal culture ? The respect and confidence of the patient are of 
immense importance to the practitioner, by inducing a hearty 
acceptance and full carrying out of a proposed plan of treatment, 
How are these to be gained, at least from intelligent and well 
educated persons, unless they can discover in their medical attend- 



244 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

ant something beyond the dry technicalities and details of profes- 
sional knowledge ? 

Even our own self-respect requires that we should be able to 
associate, on equal terms, with the best instructed of any commu- 
nity in which our lot may be cast ; and, in our country, there are 
few neighbourhoods in which sufficient intellectual light does not 
exist, at least in portions of the population, to throw deep shadows 
from extreme ignorance, whether pretending or unpretending, 
upon the path of professional success. 

But, while urging the necessity of general mental culture, I 
would put you upon your guard against a course into which it 
may lead you, full of danger to your best hopes. I refer to an 
exclusive or very obvious devotion to any one branch of science or 
literature, which may absorb your faculties and time, and with- 
draw, or seem to withdraw them from your proper professional 
pursuit. Medicine is a jealous mistress, and will bear no rival in 
your affections or attentions. She tolerates and even demands 
such accomplishments as may render her votaries more efficient in 
her service, and reflect additional splendour upon herself. But 
her deepest frowns aw T ait those who acknowledge only a divided 
fealty, or addict themselves preferably to the service of another 
mistress; and even coquetry often draws down upon her professed 
votary a withering indignation. To success in medical practice 
there are few greater impediments than a real or seeming prefer- 
able addiction to some other branch of knowledge, even though it 
may be collateral with medical science itself. The world, whether 
justly or not, will believe that time and labour must have been un- 
duly abstracted from professional devotion, and will, as a general 
rule, seek the aid of physicians, who, though generally accom- 
plished, have permitted no other attachment to encroach visibly 
upon their legitimate one. Of course, this warning is intended 
only for those who aim at the practice of medicine as their pursuit 
in life. To those, and they are not a few, who in the study of 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 245 

medicine are preparing themselves for usefulness in some collateral 
occupation, to which medicine herself is for their purposes only a 
handmaiden, the remarks just made are quite inapplicable. But I 
would reiterate that, if you propose, as your great object in life, a 
wide field of professional duty, you must let it be clearly seen that 
such is your aim, and that whatever else you may have gained 
through opportunity or diligence is to be made subservient to this 
end. To attain eminence as a poet, historian, mathematician, 
philosopher, even as a chemist or botanist, if not fatal to your 
views, will very greatly impede their fulfilment. 

3. Without further pressing the subject of general literary or 
scientific culture, I would call your attention to another profes- 
sional requisition, of considerable, if not equal importance. Physi- 
cians necessarily associate with all classes of the community, from 
the coarsest to the most refined. They come, moreover, into the 
closest relations with individual peculiarities, unprotected by the 
defences which are thrown about them in ordinary social inter- 
course, and liable to be irritated or wounded by rough or uncon- 
genial contact. It is, therefore, highly desirable that our habits 
and manner should be such as not to conflict injuriously with the 
susceptibilities of our patients. Roughness never suffers by the 
contact of the smooth and polished ; while refinement shrinks sen- 
sitively from whatever is harsh or coarse. It follows that, among 
the duties of the physician, is the cultivation of a polished manner, 
and the exercise of the amenities and courtesies of a gentleman on 
all occasions. 

Picture to yourselves the consequences which must often flow 
from the non-observance of this duty. Suppose a woman of native 
delicacy and becoming sensitiveness, brought up with the refined 
tastes and habits of the true lady, and altogether unaccustomed to 
the coarse, harsh, and slovenly in dress and manner, to be attacked 
with an illness, which, while it may possibly be dangerous, never- 
theless leaves unimpaired her powers of observation, and sensi- 



24G CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

bility to outward impressions. Suppose, also, that, from the 
necessities of the case, a practitioner is called in, previously un- 
known to the patient, and, as it happens, quite ignorant of the 
proprieties of cultivated society, or, if not ignorant, despising them. 
He enters the sick chamber abruptly, perhaps carelessly dressed, it 
may be even in his shirt-sleeves if the weather is very hot, or in a 
coarse, shaggy overcoat, if it is cold or stormy. Not having 
taken the precaution to use the scraper or the door-mat, he leaves 
at every step a soiling track upon the fine carpet. Perhaps, be- 
fore reaching the bed, he may squirt out a mouthful of tobacco- 
juice upon the floor, or make a not less disgusting deposit from 
his nasal or bronchial passages. His near approach discloses, to 
the delicate sense of the patient, that his person or breath is 
reeking with the odour of tobacco, onions, or bad whisky. He 
addresses her gruffly, seizes her wrist with a bearish gripe, makes 
further investigations without delicacy, pronounces his decisions 
abruptly, and leaves the room with as little regard to propriety as 
he entered. Now what do you suppose would be the effect on the 
patient ? Nauseated and faint with disgust, shocked by the rude- 
ness, scarcely able to appreciate his questions, and quite unable to 
answer them efficiently, she presents to him an aspect wholly dif- 
ferent from that proper to her disease,- and very likely to mislead 
his judgment. However well informed he may be professionally, 
he would probably form false or imperfect views of the case, and 
consequently prescribe incorrectly or inadequately; while the 
patient herself, without confidence in the prescriber, would submit 
reluctantly, if at all, to the measures proposed. The result might 
be a serious aggravation of the danger, possibly a fatal issue of 
the disease, which a more judicious practitioner might have 
averted. 

It may be said that this is an extreme case. I most cheerfully 
admit that it is so. I am happy to say that very few regular prac- 
titioners could be found capable of fulfilling all the conditions here 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 247 

imagined. But I appeal to your own observation, whether the 
picture might not find its prototype in real life; and, if drawn 
somewhat strongly, it may perhaps prove the more impressive. 

There are two kinds of politeness, both of which demand ob- 
servance. One is conventional, based upon custom, and therefore 
variable in different communities; the other essential, springing 
from the inherent principles of our nature, and unchangeable with 
time or place. The former consists in attention to modes of dress, 
address, movement, eating, drinking, and all the ceremonials of 
social intercourse. These, though in themselves of little import- 
ance, are connected with our well-being through their influence on 
opinion. A neglect of them occasions disapproval, ridicule, dis- 
gust, even reprobation and avoidance, and often interferes with 
social acceptance and professional success much more than moral 
obliquity, when covered over with a decent veil of propriety. I do 
not say that this is right ; but so it is, so it always has been, and so 
it will continue to be until the millennium. Few men can with- 
stand the neglects, rebukes, and indignities which follow a non- 
observance of the ordinary ceremonials of civilized society; and 
nothing but well-known conscientious scruples, an established char- 
acter for eccentricity, or extraordinary eminence in rank, wealth, or 
talent, will be admitted even as a palliative. 

To over-act in all these matters, though less offensive, exposes 
equally to ridicule. To dress and act like a fop, or show in any 
other way that the mind is wholly absorbed in these external and 
formal observances, is supposed to indicate either native deficiency 
of mind, or want of substantial attainment; and, unless counter- 
acted by palpable evidence to the contrary, will inevitably lead to 
distrust and neglect in all relations of business. 

For the medical practitioner it is necessary to avoid both these 
extremes. The great rule for him, upon all the points referred to, 
is so to appear and act as not to attract peculiar attention, or excite 
remark. Many a man of talents and high attainments has thrown 



248 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

away his chances of success in life by a neglect of this rule, and 
wonders how it has happened that he has been surpassed in the 
race by persons, whom he well knows to be less qualified substan- 
tially than himself. 

The second kind of politeness, the essential or native, which is 
only the outward expression of kind and benevolent feeling, good- 
ness of heart, sound principles, and noble sentiments, though per- 
haps less indispensable to success in a business point of view, con- 
tributes greatly to social acceptance, and the attainment of influence 
through the affection and esteem of the community. The amenities 
of a true gentleman are a coin which is everywhere current, and 
secures for its dispenser the favour of men of all modes of thinking, 
and all grades of life, because addressed to feelings and principles 
characteristic of human nature itself. Christianity is in this respect 
the very highest gentility ; because its tendencies are altogether to 
inspire the sentiments which lead to courtesy of act and manner ; 
the postponement of one's own wants or pleasure to those of others, 
the scrupulous avoidance of unnecessary offence, a kindly yet not 
intrusive interest in the happiness of all, and universal gentleness 
in deportment, and beneficence in deed. High and sanctimonious 
profession, without these fruits of the true Christian spirit, may 
always be suspected. 

Men of the world, observing the influence of these amenities of 
intercourse, whether based upon religious sentiments, or the result 
of a well-balanced nature duly cultivated, though unable or un- 
willing to attain to the inner reality, adopt its external representa- 
tive, and thus present to the world the appearances of a gentleman. 
These appearances become at length the standard ; and he who 
observes them carefully, whatever may be his genuine character, 
takes the social position, and exercises the social influence belong- 
ing to the reality ; because mankind can judge of the heart only by 
external signs. Now this outward garment of politeness, though 
thrown over an evil nature, is certainly preferable in social inter- 



CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 249 

course to its opposite rudeness, and will in a much higher degree 
promote one's worldly interest. It is a desirable acquisition for 
all, and for none more than for the members of our profession. 
You will, therefore, cultivate with great care all the courtesies 
which are considered as characteristic of the gentleman. Remem- 
ber, however, that, beyond comparison, the most successful mode of 
culture is to develope and cherish the inner virtues from which they 
naturally spring. An evil heart will occasionally, in spite of the 
most careful watchfulness, make itself visible through the garb of 
refined and polished manner; and no one can always be certain of 
himself, who wants the perennial source within, from which the out- 
ward graces of character spontaneously issue. 

4. There is one other point connected with the requirements of 
the medical profession, which cannot be omitted, without leaving 
incomplete the view I have attempted to sketch for you. Ours is 
a pursuit in which the inmost secrets of individuals and families, 
not unfrequently involving character, and sometimes even life, are 
necessarily unveiled to us ; being betrayed by the very nature of the 
disease, or entrusted to us in our professional capacity. All such 
secrets the physician is bound to keep religiously ; and no promise, 
however solemn, no oath, however awful its sanctions, can add one 
iota to the obligation, under which he is placed by the very nature 
of his calling. To his most intimate friend, even to the wife of his 
bosom, his lips must be sealed forever, so long as the slightest 
injury might, by any possibility, result from a disclosure. Though 
the person concerned might subsequently become an enemy, the 
knowledge acquired in professional attendance can rarely be used 
as a weapon even of defence. The law alone presents a higher 
obligation to his conscience ; and I can conceive of cases in which 
even this would not excuse a violation of professional confidence. 
It is, on the whole, a good rule for the medical practitioner, to say 
as little as possible, in ordinary social intercourse, of what may 
come under his notice in his rounds of attendance, even though 



250 CHARACTER AND OBJECTS OF THE MEDICAL PROFESSION. 

there may be nothing which could be looked on as a secret. To 
have the reputation of a gossiping doctor is anything but credit- 
able. To betray confidence is in the highest degree base and 
wicked, if done with an evil purpose; and is wholly inexcusable, 
if done carelessly or inadvertently. This principle you should fix 
deeply in your consciences, even at the threshold of your profes- 
sional career, and make it as it were a part of your very nature, so 
that a violation of it should be as impossible as a disregard of his 
promise, or a palpable falsehood is to an honourable man. 

In closing the address, I would ask of you to contemplate the 
general character of the profession, as I have endeavoured to pre- 
sent it, and to open your hearts to the feelings it is calculated to 
inspire. Consider its great and noble aims, the ability and knowl- 
edge requisite for its due exercise, the graces of deportment and 
character, and the high principles of honour demanded of all its 
true votaries. In a well-constituted mind, it is impossible that feel- 
ings of profound esteem and warm attachment should not spring 
up, and expand into an absorbing sentiment, under such contem- 
plation. The genuine professional spirit is thus generated, which, 
once possessed, you will find of inestimable value. It will tend to 
elevate you above all that is base, grovelling, or purely selfish ; 
will serve, even in your state of pupilage, to stimulate to honour- 
able exertion, and guard against discreditable acts of all kinds; 
and, in your future course will, next to a sense of religious obliga- 
tion, or in connection with it, be your surest guide to honour and 
usefulness in life, and happiness at its close. 



LECTURE IY. 



DELIVERED OCTOBER 13th, 1859. 



Scope of the Practice of Medicine. 

Gentlemen : — 

You know that my office in this school is to teach the theory 
and practice of medicine; in other words, the knowledge and 
treatment of disease. In order that you may enter on jthis study 
with a proper spirit, that your efforts may be duly directed in the 
course of it, and that, when it is concluded, you may be prepared 
to apply your knowledge with the best practical effect, it is advisa- 
ble that, at the very outset, you should be made acquainted, as far 
as may be, with its true nature and objects. To this purpose the 
few remarks which follow will be applied. My wish is to make 
them as precise and intelligible as possible, without ornament, or 
any attempt at display. Whatever impressiveness they may have 
must depend upon their truth. 

1. In the first place, I would inculcate upon you that the theory 
and practice of medicine is not a particular system; not a set of 
rules or precepts, based on some one dogma with pretensions to 
universal application. This narrow view of it is one which irregu- 
lar practitioners of all descriptions endeavour to impress on the 
public mind, in order to further their own ends. Regular medi- 

(251) 



252 SCOPE OF THE PRACTICE OF MEDICINE. 

cine, they say, is an old system, worn out, senile, effete ; while their 
own is new, with the vigour of full maturity, on a level with the 
times, corresponding with the advanced knowledge and higher in- 
tellect of the age. Thus they endeavour to dignify their position 
by putting themselves on the same foundation with us, and then 
claim superiority upon the score of progress and reform; the two 
great watch- words of the times, as often the cover of ignorant 
pretension and selfish cunning, as the signals of forethought and 
philanthropy. 

I would adduce a single instance. The homoeopathists, after the 
example of their founder Hahnemann, while they put forth their 
own fundamental principle, that disease is to be cured by medicines 
having an effect similar to the disease itself — an absurdity drawn 
from the musty records of our own science, similia similibus cu- 
rantur — maintain that the regular practitioners act upon the oppo- 
site rule, that the proper remedies for a disease are those which 
produce an opposite or dissimilar effect, and hence designate us by 
the nickname of allopathists. Thus, they would make the question 
before the public, not between regular and irregular medicine, but 
between homoeopathy and allopathy; the one a new system for 
which they claim the support of a transcendental reason, and a con- 
firming experience ; the other an old system, not entirely worth- 
less, adapted to the unenlightened times in which it originated, but 
quite unequal to the wisdom of the present age, and not to be 
compared with theirs. It is easily to be seen that a question of 
this kind, before the altogether ignorant and often very conceited 
tribunal of individual opinion, must frequently be decided in favour 
of him who can talk most plausibly, utter falsehoods most glibly, 
and bow most profoundly before the silly vanity of the party ad- 
dressed. Is it surprising, therefore, that homoeopathy has disciples 
and advocates in a community, quite ignorant of the subject dis- 
cussed, and especially among the more amiable and credulous sex, 
who, being true themselves, can scarcely appreciate the falsehood 



SCOPE OF THE PRACTICE OF MEDICINE. 253 

of those, who stoop to flatter either their personal or intellectual 
perfections. 

Even medical men have in many instances inconsiderately given 
in to this error, and strengthened the cause of their adversaries by 
recognizing the title of allopathy, and with it of course the prin- 
ciple upon which it was applied. I would guard you against a 
similar mistake. Not only scrupulously avoid the use of the term 
as applied to your profession, but disclaim it altogether when ap- 
plied by others. Let it be seen that the nickname is offensive, and 
that its purposed repetition would be incompatible with the cour- 
tesy of refined social intercourse. 

We are not allopathists. We do not base our plans of treat- 
ment on the asserted dogma, nor, indeed, on any other one theory 
or principle. Medicine, as a science, consists of all the knowledge 
in reference to disease which has been gathered from past ages, or 
accumulated in our own times. As a practice, it embraces all the 
means, from whatever source derived, which can be made available 
in the cure, alleviation, or prevention of disease. The physician is 
confined within no limits except those of truth and honour. He 
seeks for knowledge wherever it can be found. He would even 
receive it from the hands of the quack ; for it has that excellent 
quality that it cannot be defiled by the filth around it. He does 
not reject the systems or practices of the irregular practitioners, 
because they may be in supposed opposition to his own interests ; 
but because, enlightened as he is upon the subject of our bodily 
constitution, he knows that they are untrue ; that they are visionary 
illusions of ignorance or fanaticism, or unprincipled assumptions 
of mere charlatanism. Hence the pity or scorn with which he 
regards their professors ; pity for the few who are honest but de- 
luded ; scorn for the greater number who know what they are 
about, and seek a vile livelihood out of the ignorance, credulity, or 
imbecility of the multitude. Especially does he regard with un- 
mitigated disgust the deserters from his profession, who, having 



254 SCOPE OF THE PRACTICE OF MEDICINE. 

received light, and knowing as well as himself the worthlessness 
and noxiousness of the different forms of quackery, nevertheless 
abandon the regular practice, because it has not satisfied their aims 
of self-interest or cupidity, and throw themselves into the current 
of some popular delusion, hoping that it may bear them on to for- 
tune. These deserters, it must be acknowledged, are relatively 
very few ; and it is a subject of honest self-congratulation to our 
profession, that, in the midst of an over-crowded competition, in 
the long struggles, the disappointed hopes, and the too often fruit- 
less patience of the first years of practice, in the face too of the 
occasional gaudy and glaring successes of quackery, strutting and 
flaunting before the eyes of the astonished community, so small a 
number should be found willing to abandon their colours, or at 
least to go over to the enemy. 

I may presume, gentlemen, that you are now possessed of the 
real nature and scope of medical study ; that it is no one system, 
hypothesis, dogma or set of dogmas that you are to learn, but 
facts and philosophical deductions from them; in other words, 
simply truth in its relation to human health, gathered from the 
observation of all time, garnered up and methodized for the most 
convenient acquisition by the learner, and destined to go on in the 
course of accumulation, simplification, and improved arrangement, 
until at length it shall embrace, within a scope not beyond human 
capacity, all that a wise Providence has ordained for obviating the 
miseries of disease. 

It must be clear to you that any one hypothesis, intended to 
explain everything, and be a sufficient guide to practice in all 
cases, must be a pure assumption, and necessarily false. Attempts 
have repeatedly been made, in the history of our science, by highly 
imaginative and inventive minds, to fashion such hypotheses; and 
the medical world has been led astray by these false lights, to 
flounder in the slough of speculative error, and to reach again the 
fast ground of truth, only after long fruitless wandering, and 



SCOPE OF THE PRACTICE OF MEDICINE. 255 

wearisome struggles. A true theory can be formed only by de- 
duction from facts. Now facts enough have not been collected to 
serve as the basis of a universal theory in medicine. There are 
points in our physical constitution, of the nature of which we have 
not even a conception. We do not know what is life ; the very 
principle which governs all those operations of our system, by 
which it is distinguished from a mere physical machine. We have 
traced anatomy into its microscopic elements of molecules, fibrils, 
cells ; but we are utterly ignorant of the force which creates these 
wonderful germs, and of the laws which direct their no less won- 
derful, I might say, their sublime developments. We have learned 
enough to teach us how vague, how utterly inane have been the 
profoundest speculations in our science, having any claim to uni- 
versality; enough also to satisfy us that much, much more must 
be learned, before we can even begin to fashion such speculations 
hereafter, with the least hope of permanent acceptance. To suc- 
ceed in such an attempt, in the present state of our knowledge, 
would require a direct admission into the counsels of Omniscience, 
an inspiration proceeding immediately from the fountain of crea- 
tive wisdom; and, even were a doctrine put forth under such 
supernatural influence, it would probably be rejected by us in our 
self-sufficient ignorance ; for it would necessarily be a mystery, un- 
intelligible because we do not understand the facts upon which it 
would rest, and should, in all probability, be ignorant of the very 
meaning of the terms in which it would be expressed. 

Here then is a touchstone by which we may, to a certain extent, 
estimate the truth of any asserted medical dogma. Does it claim 
to be universal? If so, it must be untrue. We may pronounce 
as positively on this point, as the physical philosopher pronounces 
on the point of perpetual motion. Such theories, therefore, as 
homoeopathy, though a thousand times more plausible than that 
miserable absurdity, must be rejected; such universal remedies as 
the water-cure, and all other panaceas, must, from their very uni- 



256 BOOPE 01 THE PRACTICE OF MEDICINE. 

versality, be purely empirical; that is, they must be destitute of 
any basis in abstract reason, and depend for their asserted value 
solely on experience. 

Do not understand me as being opposed to all theory in medi- 
cine. To a certain extent, this is essential for the convenient 
arrangement and recollection of facts. These accumulate as the 
result of observation and research, until they at length become so 
numerous as, in their isolated state, to be quite unmanageable for any 
useful purpose. Upon examination, natural relations are found to 
exist among them ; these relations appear to depend on some prin- 
ciple common to the several series in which they are observed ; and 
the principles thus deduced serve, not only as handles to the me- 
mory, by which it may hold on to the several bundles of facts, but 
also as clues to further research. The science of medicine is full of 
such principles, and could scarcely exist as a science without them. 
It does not necessarily follow that they are all true. They may 
be considered so, if found applicable to every fact professed to be 
embraced by them. We may, for convenience sake, admit their 
truth provisionally, even though there may be some apparent ex- 
ceptions ; for it may be hoped that these exceptions will, in the 
end, prove to have been merely apparent. They must be aban- 
doned when any fact is discovered, and established beyond doubt, 
which is quite incompatible with them. But, even though rejected 
with the advance of knowledge, they have served a useful purpose, 
and tended on the whole to the improvement of science. 

What I especially wish to guard you against is the acceptance 
of any one universal, and of course exclusive hypothesis, which in 
the nature of things cannot be true, unless a direct revelation from 
Omniscience, and which, if untrue, and yet adopted and acted on, 
must lead to inexpressible evil. Even in relation to the partial 
principles referred to, you should be on your guard not to let them 
sway you too exclusively, so as to close your eyes and your will 
against truths that may be hostile or even fatal to them. 



SCOPE OP THE PRACTICE OF MEDICINE. 257 

With the reiteration then of the statement, that the science of 
medicine, as it now exists, is not one exclusive system, and cannot 
therefore be in opposition to, or in fact have any relation with, any 
such asserted system ; and with the repetition of the advice, that 
you should on all occasions disclaim and reject this false position 
in which the enemies of regular medicine, whether original or 
renegade, would desire to place you, I leave this branch of the 
subject, and proceed to another point, in relation to your future 
profession, scarcely less important than the one discussed. 

2. The point referred to is, that the science of medicine is yet 
imperfect, and its powers limited. The practical inferences are, 
that you are not to expect too much from it, and should be spe- 
cially careful not to claim more credit than may be justly due to 
you in its exercise. 

Some diseases are in the present state of our knowledge quite 
incurable. Many run a certain course which medicine may in some 
degree regulate, but cannot interrupt, unless by the destruction or 
at the great risk of life. Others, again, may be influenced both in 
degree and duration, and may often be cut short with advantage. 

Now it must be quite obvious to you that any one general plan 
of management cannot be adapted to these several varieties. The 
incurable you must be content to palliate, until some new dis- 
covery shall remove them from that sad category. Those of defi- 
nite course and duration you must manage cautiously, aiming not 
at their immediate cure, but simply to prevent mischief in their 
progress, so that they may eventuate favourably when the period 
for their termination shall come. Unhappily, they will in many 
instances prove too strong for you, even with the appliance of your 
best skill; but very often also you will, by good management, con- 
duct to a safe issue cases which might have proved fatal without 
you. In reference to the third set of diseases, those, namely, with- 
out fixed duration or end, you will be determined in your course 
by the degree of apparent danger. Yery often, I might say in the 

It 



258 SCOPE OF THE PRACTICE OF MEDICINE. 

vast majority of cases, they will terminate favourably in their own 
natural course, without any interference, and not unfrequently in 
spite of very improper and even injurious interference. Here it 
would be the height of folly to medicate vigorously ; as it would 
be the height of impudence or of ignorance to claim the merit of 
success from measures, which could have had no other effect than 
to incommode the patient, protract the disease, or endanger the 
result ; or, at the very best, to hasten a cure at the hazard of the 
patient, which would have occurred without any risk at a some- 
what later period. It is only where danger, or suffering, or great 
inconvenience may be obviated, that vigorous treatment is admis- 
sible in such affections ; and, as occasions of this kind are not un- 
frequently presented, the physician must be prepared, with all his 
habitual caution, to act when requisite with great promptitude and 
energy. 

From this brief sketch you will at once perceive how utterly 
impossible it must be for an uninformed man to treat disease pro- 
perly, and what an awful responsibility they assume who run head- 
long into practice, with very imperfect preparation, or with no 
preparation whatever. 

I have said that you are not to expect too much from medicine. 
The young practitioner is peculiarly liable to error in this respect. 
He is apt to have great confidence in therapeutics, and conse- 
quently to wield its resources with an unsparing hand. Experience 
in time generally convinces him of his mistake, and then he is in 
danger of running into the opposite and equally incorrect extreme 
of skepticism. It is certainly best to start with correct views on 
this point. 

We have had examples of both of these extremes in the practice 
respectively of the old English and French physicians. The former, 
who were copied by the Americans, were in the habit of using me- 
dicines in great excess. The ideas of disease and of drugs were 
inseparably associated in their minds ; the dosing of a patient was 






SCOPE OF THE PRACTICE OF MEDICINE. 259 

considered to be the main business of the physician ; and no matter 
what the nature of the complaint, whether mild or severe, curable 
or incurable, self-terminating or otherwise, it would have been 
deemed unpardonable to let a case end either in recovery or death, 
without its full share of medication. Of course, I am speaking only 
in general terms. There were always individual practitioners who 
had escaped the trammels of prejudice, and allowed themselves to 
be guided by the lights of reason and a well-considered experience. 
But of the general truth of the statement there can be no doubt. 

The source of this over-practice may be traced in part to the 
peculiar state of the profession in England. As before observed, 
the natural tendency of the young practitioner is to this extreme ; 
and the same may be said of the youthful period of the profession. 
But there were causes of a special character acting among our 
English predecessors. The practice was divided between two classes 
of medical men, the physicians and the apothecaries. The former 
only prescribed, and, having no legal claim for remuneration, re- 
ceived an honorary fee at each visit. The latter both prescribed 
and furnished medicine, and, being protected by the law in their 
claims for compensation, so far as the medicines were concerned, 
though not for their advice, were paid not at the time of the visit, 
but subsequently, upon rendering their account, as is the case among 
ourselves. But, being allowed to charge only for the medicines 
supplied, they were irresistibly tempted, in order to swell their 
income, not only to affix an extravagant price to their medicines, 
but also to prescribe them extravagantly, and not altogether in 
reference to the wants of the case. Our views of right are noto- 
riously affected by our supposed interests ; and, finding that exces- 
sive medication was essential to their livelihood, they very naturally 
came to deem it essential also to the patient; and this habit of 
prescribing was accordingly established among them. But it may 
be asked, how did these circumstances affect the class of physicians ? 
Upon the same principle exactly. The apothecaries were those in 



260 SCOPE OF THE PRACTICE OP MEDICINE. 

general first called in, and might be considered as the regular family 
attendants. The aid 'Of the physician was sought in consultation, 
when the case became serious. Now the apothecary could very 
often determine what physician should be sent for, and thus had it 
in his power greatly to promote the success of those whom he 
might be disposed to favour. The physician could not be un- 
grateful. It would be unfair in him to lessen the profits of his 
benefactor ; and he also, in the regular course of things, came to 
see the importance of a multiplicity of medicines, and of a free use 
of those selected. As our medical knowledge and habits of prac- 
tice, in this country, were derived mainly from English books and 
English tuition or example, we also fell into this vicious system of 
excessive medication, though never hampered by the same absurd 
classification of the profession as that which prevailed in Great 
Britain. 

But a new era arose with us, beginning with the teachings of 
Rush, which had a great tendency to the simplification of medi- 
cines, and much promoted by the direction of opinion towards the 
French views of medicine, when the pathological doctrines of 
Broussais were propagated among us. To this medical reformer, 
though I was never one of his disciples, and though his peculiar 
views have at present few or no advocates, we are, I think, mainly 
indebted for the great change of sentiment, on the point in question, 
which has been going on during the last thirty or forty years. We 
must admit also that the practice of the homceopathists has contrib- 
uted to the same end, by demonstrating how much nature can 
accomplish when wholly unassisted ; for genuine homoeopathy, as 
you know, with all its wordy pretensions, is nothing more nor less 
than a skilfully contrived plan of doing nothing : I say skilfully 
contrived ; because it has certainly succeeded in imposing itself on 
great multitudes for an efficient agency, and thus filching from 
nature a credit to which it has no claim whatever. This is one 
only out of the innumerable instances in which, by the orderings 



SCOPE OP THE PRACTICE OP MEDICINE. 261 

of an all-wise Providence, good is deduced from evil. It is, indeed, 
a most happy circumstance in the constitution of the universe, that 
wickedness in every shape leads to some ultimate good ; and that 
while, in the little circle of their experience, the servants of his 
Satanic majesty seem to be working only in the cause of their 
master, there is an overruling intelligence, which is ever inter- 
twining their bad deeds into that eternal bond, which connects all 
things in one great system of glory to God and good-will to man. 

You are not, then, to expect too much from medicine. You will 
make it a special subject of investigation, how far our present lights 
enable us to proceed with sure steps into the wilderness of thera- 
peutics ; you may justly and even laudably endeavour by your own 
efforts to widen this circle of illumination ; but, having gone thus 
far, stop; venture not unguardedly into the darkness; rush not 
headlong into the unexplored intricacies ; for the inevitable conse- 
quence will be that you will go astray, and may drag with you the 
happiness and lives of those who may have" put their trust in your 
skill and prudence. « 

There was another practical point connected with the imperfec- 
tion of our science to which I alluded, and to which L would more 
particularly invite your attention ; the propriety, namely, on the 
part of the physician, of claiming no more than his clue in esti- 
mating the results of treatment. In the vast majority of cases 
that will come under your care, it will be to nature and not to 
yourselves that the cure will be justly ascribable. You may dimin- 
ish suffering in these cases, perhaps not unfrequently shorten their 
duration ; but they would get well without you. Now it would be 
stooping to the level of the quack, at least in one of the most char- 
acteristic of his habitual proceedings, to take to yourselves the 
whole merit here. If done ignorantly, it would be a strong proof 
of defective knowledge of disease, and of unfitness for its manage- 
ment ; if knowingly, and with the object of producing a favourable 
impression of your own skill, it would be dishonourable if not posi- 



202 SCOPE OF THE PRACTICE OF MEDICINE. 

lively dishonest, and quite incompatible with the character of a 
high-minded man. Two great evils flow from this bad habit, one 
relating to the individual himself, the other to the profession and 
the public. The practitioner who sees in every recovery a cure 
effected by his skill, is apt to acquire an overweening confidence 
in his own powers, and to neglect utterly those means of self- 
improvement, which a becoming modesty would lead him to seek 
for, and to employ diligently when within his reach. He thus 
remains ignorant, and is apt to become self-sufficient, and some- 
times even ludicrously pompous in the eyes of better informed men. 
To the interests of the profession and the public the conse- 
quences are still more serious. If in all cases of recovery under 
medical treatment, the people are taught that a cure has been 
effected by the physician, they will naturally infer that diseases are 
never self-terminable, that when they end well the result must be 
ascribed to the means used, and consequently that a favourable 
issue is a proof of the efficiency of those means in every instance. 
You can readily perceive the evil that must ensue. It often hap- 
pens that, in the absence of regular professional aid, some supposed 
remedy is administered, perhaps harmless, perhaps noxious, but at 
all events wholly inapplicable to the case, which nevertheless ends 
in recovery. The experiment is repeated in other cases with the 
same result. Now it will be inferred by the experimenter that the 
remedy is really efficacious, and, relying upon his supposed expe- 
rience, he will be induced to administer it in all similar cases, with 
the effect probably in some of aggravating the disease, in some 
possibly of rendering it fatal, either by a direct injurious impres- 
sion, or by the exclusion of positively curative methods. If the 
physician has set the example of claiming what he does not merit, 
and taken no pains to enlighten the public mind on this point, the 
result will be inevitable. Ignorant people will acquire confidence 
in their own power, or that of others equally ignorant, in the treat- 
ment of disease. All sorts of inert or inappropriate medicaments 



SCOPE OF THE PRACTICE OP MEDICINE. 263 

will get into vogue as popular remedies. The claims of irregular 
practitioners will be admitted, and quackery in all its forms will ob- 
tain more or less of the public confidence. This is, indeed, the great 
support of irregular medicine. Patients get well under the nothings 
of homoeopathy. These nothings are much more acceptable to the 
delicate or pampered taste than the nauseousness of positive reme- 
dies. The people are taught by their physicians that a recovery 
is a cure. The recoveries under the homoeopathist are therefore 
cures ; and, as he offends the sensibilities of the palate and stomach 
less than the regular practitioner, he is preferred to the latter by 
the squeamish, who are apt to be found among the most cultivated, 
and especially in the softer, and, in this respect, more influential 
sex. For those who cannot have faith in the power of infinite 
littleness, whose coarse and homely judgments cannot recognize 
the transcendental efficacy, evolved by a certain number of shakes 
made in a certain way ; for such as these there is the more sub- 
stantial treatment of vulgar quackery ; and the countless multitude 
of panaceas — the pills, the powders, the syrups, proclaimed every- 
where as infallible by their shameless advocates, all positive, and 
consequently all capable of great mischief — become the false lights, 
which too often lead the ignorant into morasses, from which they 
may or may not flounder into health. 

The physician then, who demands in all instances of favourable 
result the credit of a cure, is playing directly into the hands of the 
irregulars. If his recoveries are necessarily cures, so also are 
those of the quack. He cannot escape this dilemma. He may 
assert that a larger ratio of recoveries takes place under his man- 
agement ; but his opponent will assert the same, and with greater 
effect, just in proportion as he is more unscrupulous. Accurate 
statistics, in such matters, can scarcely be brought to bear on the 
public faith ; confident assertion and reckless falsification will be 
most apt to carry the day; and I need not tell you which class 
can wield these instruments most effectively. 



264 SCOPE OF THE PRACTICE OF MEDICINE. 

But the regular practitioner may object that, if we teach the 
public how little we really do, and how much is done by nature, 
they will be apt to desert us entirely, and either trust to her cheap 
aid, or have recourse to the more highly professing empirics. 
Supposing this to be true, is it an argument for dishonourable 
proceedings on our part? Are we, professing to be honourable 
and high-minded men, to cheat the public into our support? and 
should we not by such conduct countenance quackery in all its 
forms, and every other species of humbug ? Better far abandon 
our profession, and seek a livelihood in some honest calling, how- 
ever humble. 

But this is a needless fear. Providence has not so arranged 
affairs in this world, that, in one of the noblest and most ennobling 
pursuits in which man can engage, falsehood should be essential 
to success. At the same time that the people are taught truly in 
relation to the spontaneous curability of most diseases, they will 
also be taught that many cases can end favourably only under 
appropriate management ; that many others, if left to themselves, 
though they may not prove fatal, may without proper attention 
degenerate into long-continued and troublesome chronic affections ; 
and that even of those to the cure of which nature may be ade- 
quate, almost all may be rendered by the skilful physician less 
painful, and the greater number materially shortened. These ad- 
vantages can be appreciated by the most obtuse judgment ; and 
the regular physician will be the more readily believed in all that 
he claims, when it is known that, in what he disclaims, he tells the 
truth to his own apparent loss. Besides, the sick are seldom able 
to appreciate their own real condition; and, even in those in- 
stances where little is required, fearing the worst, they will be apt 
to apply to the physician for his counsel, especially if they have 
learned to trust him, and to believe that he will not unnecessarily 
burden them either with medicine or attendance. 

3. But, while I would guard you against an overweening confi- 



SCOPE OP THE PRACTICE OP MEDICINE. 265 

dence in medicine, I would equally warn you against that sense- 
less skepticism, which is but the too natural result, in a badly 
balanced mind, of reaction from an overstrained faith. Bigotry, 
in our profession as in religion, when it yields before the light of 
reason, is too apt to seek refuge in absolute infidelity. Another 
source of this want of confidence in therapeutics is a too exclusive 
devotion to medicine as a science, to the study of the structure 
and functions of the system both in health and disease, rather than 
to the means of restoring that structure and those functions to 
their normal state when deranged. An exclusive addiction to 
any one pursuit is apt to narrow the mind against the reception of 
knowledge from other sources. Hence, the profound mathemati- 
cian is often nothing else than a mathematician, the linguist than 
a linguist; and it is notorious how often the poet, who cultivates 
only the imagination and the feelings, and lives in the unreal, is 
wholly unfit for the struggles of this sublunary world. So is it 
with the medical student who surrenders himself, with a too par- 
tial zeal, to the studies of physiology and pathology. He neglects 
of course the practical and most important branch of his subject, 
and comes at length to doubt or disbelieve in the existence of 
remedial influences, at least of such as art can wield. Hence pro- 
bably the medical skepticism of many of the profound pathologists 
of Europe, who study diseases as the botanist studies vegetable 
nature, and the geologist the structure of the globe, simply to learn 
what they are, not with a view to alter or amend them; science 
being with them the end instead of the means. Now admiration 
of these great men, on the part of the pupil, not unfrequently -ex- 
tends to their errors and deficiencies as well as their excellencies ; 
and hence another source, in unfortunate example, of the skep- 
ticism referred to. 

You may possibly be sufficiently protected against this serious 
evil by a knowledge of its existence and ordinary sources, so that 
you may know where to be on the watch. But it is desirable that 



2f>6 SCOPE OF THE PRACTICE OP MEDICINE. 

your assurance of the efficacy of medicine, of its frequently indis- 
pensable instrumentality in the preservation of life, should be based 
on positive and conclusive evidence. Of this nature is the testi- 
mony of the best informed, the most experienced, and the most 
honourable, not only among the living, but also in the long 
series of those, who have left behind their recorded experience for 
the benefit of mankind. This testimony, while it admits the in- 
curability of some diseases, and the occasional insufficiency of all 
known measures to the cure of others, is united upon the point of 
the great utility of therapeutics properly applied. These men 
cannot all have wished to deceive; it is scarcely possible that they 
can all have deceived themselves. Their combined evidence is, 
therefore, to a certain extent, irresistible to a sound and unpre- 
judiced judgment. Give due weight to their assurances, and you 
will be spared the skepticism which might possibly result from a 
one-sided direction of your confidence, and of your studies. 

But your rational convictions may be strengthened by personal 
observation. Watch the bedside of patients in private and hos- 
pital practice; observe the progress of various chronic diseases 
before and after the commencement of a course of judicious treat- 
ment ; compare the result with that of other similar cases aban- 
doned exclusively to nature; do all this in the most cautious 
manner, and with the most impartial spirit; and, depend upon 
it, you will come out warm advocates for the efficiency of thera- 
peutics. 

Besides, is it at all consistent with the general course of Provi- 
dence, to suppose that so great an evil as disease should have 
been allowed to exist, without some remedy at the command of 
the afflicted? In physical nature, do we not observe constant 
efforts for the repair of injury ? Floods devastate the earth. But 
notice the deposit upon their shores gradually rising, and rising, 
and at length confining them within due limits, and rendering 
them essential agents of good. Volcanos pour forth their over- 



SCOPE OF THE 'PRACTICE OF MEDICINE. 267 

whelming torrents of lava, which hardens as it cools, and buries 
whole regions in a rocky tomb. But the winds and the rains 
soften the indurated surface, and clothe it in fine with a fruitful 
soil. The tempest, the earthquake, or other great physical 
agency, rends mountains asunder; and huge rocky masses topple 
from their heights, and spread ruin over the fruitful valleys at their 
base. But here again the flinty surface undergoes a gradual dis- 
integration ; the sharp angles are rounded off, the rough cavities 
are filled up ; and what was a wide scene of desolation becomes 
beautiful with swelling heights, and soft declivities, and meandering 
streams, smiling with verdure and with flowers. 

So also is it in animated nature. Look at the broken or 
wounded plant, and observe by what a beautiful process the injury 
is repaired, and even its vestiges ultimately effaced. Those of 
you who have paid the least attention to physiology know well, 
with what resources the animal system has been provided for the 
repair of injuries, and the restoration of lost parts. 

In the higher moral world the analogy with the physical is in 
this respect complete. The history of nations and of individuals 
is often but a series of successful efforts to avoid and repair injury. 
From the cradle to the grave we are called on to mourn for losses 
which are the inevitable lot of humanity ; and, but for the happy 
remedial influences which nature in various ways brings to bear 
upon us, our experience in this world would be too often of almost 
unmitigated suffering. What is the great scheme of Christianity 
itself, but a glorious remedy provided by the all-good and all-mer- 
ciful, to save a sinful world ? 

Is it possible then that Providence should have placed man in 
the midst of noxious influences, have given him an inquiring spirit 
to search, an intelligence to apply, and an inborn irresistible hope 
to use efficiently, means for counteracting these influences, and 
have done all this with no other purpose than to deceive and dis- 
appoint? To me the notion is inconceivable; altogether incon- 



208 SCOPE OF THE PRACTICE OF MEDICINE. 

sistent with our convictions of the joint power and goodness of the 
Creator. 

There are remedies for our diseases; for all of them, I believe, 
not essentially fatal by an interference already exercised with the 
processes of life. Many of these remedies have been discovered ; 
many yet remain concealed to reward future research. Compare 
the past with the present, and from this comparison infer how 
much is to be hoped for the future. To refer simply to two in- 
stances, the one prophylactic, the other remedial; I would call to 
your attention the preventive power of vaccination over small-pox, 
and the curative influence of Peruvian bark over miasmatic dis- 
eases. These two scourges, which formerly devastated the globe, 
are now brought into comparative subjection to the power of man. 
Thus will it probably sometime be with diseases still essentially 
incurable, or extensively destructive by their violence. Cancer 
and consumption, yellow fever and cholera, are yet, it may be 
hoped, to come within the certain control of medicine. 

Guard, therefore, your faith, in the efficiency of the profession 
you are about to enter. But you have another office to perform. 
It will become your duty to impart faith also to the non-profes- 
sional community, and to cherish and preserve it when already ex- 
isting. For this purpose it will be necessary for you to employ 
all the resources of your judgment and reason; but beyond com- 
parison the most efficient agency will be that of your example. 
You must not only by your conduct show that you have faith 
yourselves, but must labour zealously for those qualifications, by 
which you will be able to set forth in practice the principles you 
inculcate by precept. Make yourselves conversant with all that 
is good in medicine, and you will through life exhibit to the pub- 
lic, in your persons and conduct, an ever-present and irrefragable 
proof of the real value of our science. When the whole profes- 
sion shall have elevated itself to a high standard of character and 
attainment, it may bid defiance alike to the open assaults and 






SCOPE OF THE PRACTICE OF MEDICINE. 269 

covert stratagems of its enemies. Ignorance, superstition, and 
weak-mindedness will probably, until the mellennium shall come, 
afford a refuge for the frauds of charlatanism in ours as in all 
other pursuits ; but we can afford to be content with this when we 
shall have on our side the intelligence and worth of the com- 
munity; for these will, as a general rule, govern even the unin- 
formed masses ; and it will be only in the darkest quarters, and 
the most remote haunts of the moral world, that quackery will be 
able to show its face. 

I have at present but one further remark to make. All that I 
have said must have been uttered to little purpose, if it do not 
tend to confirm and stimulate you in all proper effort in the 
honourable course which you have entered. Keep ever before you 
the great ends of your studies, the incalculable importance of the 
duties which are to devolve upon you, and the awful responsibility 
connected with the discharge of those duties ; and you will spare no 
endeavours to avail yourselves to their full extent of the advantages 
now offered, so that, when you ultimately leave us, you may go 
forth accomplished physicians, prepared at once to encounter dis- 
ease most successfully, and to offer before the public, in your lives 
and character, a convincing proof of the truth, the power for good, 
and the pure and lofty aims of your noble profession. 



TWO 

INTRODUCTORY LECTURES, 

GIVING THE RESULTS 
or 

PROFESSIONAL OBSERVATIONS 
IN EUROPE. 



LECTURES 



THE MEDICAL PROFESSION IN EUROPE, 



Prefatory Remarks. 

The two following lectures were delivered as introductories, the first, 
in the year 1848, to the course of materia medica, the second, in 1853, 
to the course of the theory and practice of medicine, in the University 
of Pennsylvania. As my travels, during my first visit to Europe, were 
confined to Great Britain and Ireland, the first lecture refers exclu- 
sively to professional observations made in those islands. The visit 
made in the summer of 1853 extended also to the continent; and it is 
to the state of the profession in this portion of Europe that the second 
lecture is confined. In both, the statements made are extremely gen- 
eral ; as it was necessary to confine the matter within such limits as 
not to exceed the time usually appropriated to introductories. As 
regards Great Britain, some of the observations are no longer justly 
applicable, at least in their full extent ; as the state of the profession has 
within a few years undergone considerable change ; and a movement of 
reform has commenced, which will in all probability lead ultimately to 

18 (2T3) 



2T4 INTRODUCTORY LECTURES. 

the bost results. Of these one of the most important is the consolida- 
tion of the three pharmacopoeias, those, namely, of London, Edinburgh, 
and Dublin, into one, which is to constitute the pharmaceutical code of 
the whole empire. The benefits of the uniformity thus introduced, will 
be extended, in some degree, to this country, where British medical 
works are so much read, and where the confusion of British pharmacy 
has sometimes been productive of considerable embarrassment. 



LECTURE I 



DELIVERED OCTOBER 19th, 184S. 



The Medical Profession in Great Britain. 

It is a good general rule that an introductory lecture should 
have a close relation to the subject of study which it proposes to 
introduce. This rule I have generally observed in my preliminary 
addresses to the medical class. But the ways of man's conduct in 
life, like those for his feet, cannot always be rigidly straight. They 
must be accommodated in the one case to the irregularities of cir- 
cumstance, as in the other to the inequalities of surface. My posi- 
tion at present is, I think, such as to require of me a deviation from 
the ordinary course. Recently returned from travel in a foreign 
country, I may be reasonably expected to impart to those whom it 
is my duty to instruct some of that knowledge, having reference to 
our common pursuit, which I may have gathered while absent. I 
know of no opportunity better adapted to this purpose than that 
offered by the opening of a course of instruction, before the atten- 
tion has yet been engaged in a regular series of observation and 
study, which it might be inconvenient to interrupt. You will, there- 
fore, excuse, perhaps you may even commend me, if, on the present 
occasion, omitting all mention of the materia medica, the teaching 
of which is my special function, I shall in its place introduce to 
you a subject from abroad, and one no less important than that of 

(275) 



2tG THE MEDICAL PROFESSION IN GREAT BRITAIN. 

the state of the medical profession in the British Islands. This is 
so peculiar, so different from what prevails in the United States, 
that it cannot but be an object of interest to all among you who 
have an inquiring spirit; and, considering the high civilization of 
that great country, the source of so much in every department of 
knowledge and art that we ourselves boast of, its arrangements in 
relation to a profession, so influential as that of medicine, must 
offer many valuable lessons, whether for imitation or for warning. 

The present organization of the medical profession in Great 
Britain, like her political constitution and common law, has been 
the gradual growth of her wants or necessities, without any pre- 
concerted or consistent plan. Unfortunately, accidental influences 
have been less successful in shaping institutions to the require- 
ments of the case in this than in the other branches of public con- 
cernment; probably because medical knowledge lies less within the 
scope of mere human reason, and demands more of slow, patient, 
and persevering research, than either the political or the legal. 
Place together a number of individuals of Anglo-Saxon origin, 
beyond the pale of established government or acknowledged law; 
and, by the mere force of judgment, they will arrange themselves, 
almost as by a process of crystallization, into a regular and orderly 
community, with an organic constitution, and a legal code, admira- 
bly adapted to their wants. But their medical system, unless under 
instructed professional oversight, will scarcely rise above the em- 
piricism of savage tribes; being withdrawn from the control of 
reason, which is powerless when unsupported by facts, and given 
up to the caprices of the passions and imagination. It could not 
be expected, therefore, that a medical polity, which has grown out 
of mere accidental circumstances, should exhibit the same beautiful 
appropriateness to the condition of the community as may charac- 
terize a similarly originating system of law and government. It is 
uuiversally acknowledged in England that the organization of me- 
dicine in that country is defective ; and that, with a vast amount 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 211 

of individual learning, skill, and devotedness, the general economy 
of the profession is not upon the same elevated level as the other 
great national interests. 

The medical and pharmaceutical professions in England embrace 
four bodies of practitioners more or less distinct; the physicians, 
the surgeons, the apothecaries or general practitioners, and the 
chemists and druggists. Of these, the physicians practise medi- 
cine either exclusively, or in connection with obstetrics; the sur- 
geons, strictly so called, are confined to operations, and the treat- 
ment of affections generally denominated surgical ; the apothecaries 
combine the occupations of the pharmaceutist, the physician, the 
obstetrician, and often of the surgeon, under the name of general 
practitioners ; and the chemists and druggists are restricted to 
pharmacy, in other words, are identical with the apothecaries of 
this country. The last-mentioned body, as they practise neither 
medicine nor surgery, but confine themselves to the preparation 
and sale of drugs, cannot be considered as belonging to the medical 
profession, and will, therefore, be omitted in the remarks I am about 
to offer. I will simply observe of them, that they are relatively few ; 
being confined for the most part to the larger towns, where they 
more than share their business with the apothecaries. They are, 
however, increasing in numbers, qualifications, and standing; and 
it is to be hoped that the time may come, when they may supersede 
their present rivals, and, compelling these into their medical func- 
tions exclusively, may get possession of the whole pharmaceutical 
business, at least in all places where the population is sufficiently 
numerous to support an independent drug establishment. 

Of the three divisions which together constitute the great medi- 
cal body of the country, the physicians hold the highest rank; 
though it cannot be denied that individual surgeons, by great 
talents and extraordinary success, have raised themselves to an 
eminence, not surpassed by any belonging to the more elevated 
branch of the profession. All are entitled to the name of physi- 



278 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

chin wlio have graduated in a British or foreign university, or have 
become licentiates of the Royal College of Physicians of London. 
But there are certain regulations which limit the privilege of prac- 
tising, at least the legal privilege, within narrower bounds. Thus, 
by the charter of the College of Physicians, that body has the power 
of preventing any one from practising as a physician in London, or 
within seven miles of that city, who has not submitted to its exami- 
nations, and received its license ; and may even enforce its privi- 
leges by fine and imprisonment against those who reject its author- 
ity. All the regular London physicians are licentiates or fellows of 
the College ; the latter being the proper members of the body, and 
supplied by annual election from among the former. In relation 
to England and Wales beyond the limits just mentioned, I find it 
stated in the London and Provincial Medical Directory, that the 
only legal physicians are the licentiates and extra-licentiates of 
the College of Physicians, and the licentiates of the Universities of 
Oxford and Cambridge, to whom I presume should be added the 
graduates of the London University. Extra-licentiates are those 
permitted to practise only beyond the bounds of London and its 
vicinity. They undergo a different and probably less strict exami- 
nation, and are required to pay less than one-half the diploma fees 
demanded of the licentiate, which are very large, being not much 
short of three hundred dollars. But, though physicians, in the 
legal sense, may be thus limited, yet, according to the same book, 
the graduates of the Scotch and foreign universities have long 
been admitted by the College as licentiates; so that the fact of 
graduation is in reality sufficient authority to practise. When 
attending the late annual meeting of the Provincial Medical Asso- 
ciation at Bath in England, I was accosted by a gentleman, who 
informed me that he had been one of my pupils, having attended 
lectures and graduated in the University of Pennsylvania. He was 
an Englishman by birth, had for some reason which I did not learn 
chosen to obtain his medical education in the United States: and, 






THE MEDICAL PROFESSION IN GREAT BRITAIN. 27 9 

having received the honours of this school, had returned to his 
native country, and was now practising acceptably in one of its 
noblest cities, with no other authority than that of his American 
diploma. 

Having told you who the physicians of England are, I will next 
tell you what they do. It may seem strange to you that any in- 
formation should be needed on this point; and yet, if your notions 
were to be formed exclusively from what you are familiar with on 
this side of the Atlantic, you would have but an imperfect concep- 
tion of the professional habits of the English physician. Many of 
you, I dare say, fancy him to be a man out early and at home late ; 
riding from house to house on horseback, or in his one-horse 
vehicle ; at the beck and call of any one who may wish to see him 
whether by day or by night; carrying his medicines along with 
him ; turning his hand to everything that may offer ; at one time 
using the lancet, at another dressing a wound or an ulcer ; now 
perhaps extracting a tooth, and then superintending a labour; and, 
at the end of the day's work, noting the results in his account- 
book, and congratulating himself that, at the expiration of the 
year, he may, by sending out bills, gather in enough to feed, clothe, 
and warm his family. A London or even provincial physician in 
England would smile at this notion of his day's work. The fact is 
that he rarely touches a medicine, eschews all surgical offices as 
beneath the dignity of his position, would probably as soon think 
of performing the part of an executioner as that of a bleeder or 
tooth-drawer, and yields up obstetrics with the greatest possible 
good-will to the general practitioner, or to the few who make it a 
special duty. His business is purely to give advice and to pre- 
scribe. The metropolitan physician seldom leaves home before 
twelve or one o'clock, and then drives out with his chariot and 
pair; and a fine equipage is almost as necessary an appendage as 
a hat or a coat. Much of his most profitable business is at his own 
house, where he receives calls and gives advice after his breakfast 



280 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

hour; the patients being admitted into a reception room, and one 
by one entering the sanctum in their turn. Yery many of his visits 
are in consultation with the general practitioner, who is usually 
called upon at the commencement of the disease and in mild cases, 
and asks the aid of the physician when the symptoms become grave 
or obstinate. Not unfrequently he makes but one visit, waiting to 
be again summoned by the attending practitioner before repeat- 
ing it. The wealthy only can afford the luxury of continued and 
regular attendance from the physician. In this country, the nearest 
approach to the ordinary practice of the English physician is that 
of a medical man of established reputation in one of our larger 
towns, who, wishing to limit his business, confines himself as much 
as possible to the giving of advice at home, and a consultation 
business abroad. But here the analogy ceases. The mode of com- 
pensation differs entirely. With us, each piece* of service is noted 
in the day-book, and a bill rendered for the whole at stated periods. 
In England, the service is paid for when received. We charge one 
or two dollars a visit, they expect a guinea or about five dollars. 
We have a legal claim for our fee, and often lose it. They have 
no legal claim for theirs, and are sure to get it. A physician in 
this country may, if fully occupied, in the most favourable situa- 
tions, make eight or ten thousand dollars a year ; a London physi- 
cian of high repute not unfrequently receives five thousand pounds, 
equivalent to nearly twenty-five thousand dollars, and sometimes 
doubles that income. It is remarkable how our sensibilities accom- 
modate themselves to the peculiar circumstances of our position. 
The physician in England thinks that to send in a bill for attend- 
ance would level him with the mechanic, and looks with something 
like contempt on the practice. I confess that to hold out my hand 
for money, at each visit, would be repugnant to my sense of deli- 
cacy. I should feel as if I were reducing an honorary to a mer- 
cenary service. It seems to me that the practitioner, under such 
circumstances, though he may not absolutely repeat the servile 






THE MEDICAL PROFESSION IN GREAT BRITAIN. 281 

formula — remember the physician — must have the words in his 
heart. 

The number of physicians is small, compared with that of the 
other classes of medical practitioners. They are almost all well- 
educated, many of them highly-educated men ; and, indeed, a good 
preliminary education is a necessary prerequisite to an examination 
for the medical diploma, in all the English institutions which have 
the authority to grant it. They are also men generally of culti- 
vated manners, and have the moral tone as well as exterior polish 
which characterize the gentleman. Though inferior in rank to the 
higher aristocracy of the kingdom, they associate often upon equal 
terms with the best society; and we occasionally see it announced 
in the Court Journal, that some physician of eminence has been 
honoured with a seat at the queen's own table. They frequently 
have great influence with men in power, and with the community 
among whom they live. I repeatedly met with physicians in the 
large provincial towns, who either were, at the time, or had been 
mayors of their respective corporations ; and that position is even 
more honourable and influential in England than in this country. 
Their professional success is very precarious. It is, for the most 
part, after long waiting, and many of those delays which make the 
heart sick, that they become firmly established ; and the greater 
portion can expect little more than to make a respectable liveli- 
hood. Now and then, however, an encouraging instance of great 
success occurs among them, leading to both fame and fortune, and 
serving as a beacon-light to ambitious aspirants. The system of 
high fees enables one who can obtain a large practice among the 
opulent to reap abundant emolument; while it does not altogether 
prevent others from obtaining practice among the middling and 
poorer classes ; for, though precluded by the general sentiment of 
his class, which has almost the force of law, from accepting less 
than a guinea for each visit, he may attain the same end by declin- 
ing compensation for every second or every third visit, or even for 



282 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

two out of three visits, so as to bring the fees in fact nearly on a 
level with ours. 

From the physicians of England I personally met, whenever I 
came in contact with them, the utmost courtesy, and to many I am 
indebted for very kind attentions. To Drs. Pereira and Christison 
especially, who may perhaps have recognized congeniality of pur- 
suit as a stronger claim on their hospitality than mere professional 
brotherhood, I would express a peculiar obligation ; and, should 
this acknowledgment ever reach them, I hope they will still further 
add to their kindness by excusing the use, which, under the impulse 
of feeling, I have ventured to make of their names on so public an 
occasion. 

The second division of practitioners before alluded to, or the 
proper surgeons, are those who profess to deal only with surgical 
affections, with the addition in some instances perhaps of ob- 
stetrics. They do not seek a diploma in medicine, and have no 
special designation to distinguish them from other members of the 
community. To the eminent surgeon it is offensive to be styled 
doctor; because the giving of a title, to which he has no claim, 
would seem to imply that his consequence may be added to by 
something extraneous to his own merits or position. Though 
none are prohibited by law from assuming the name and character 
of a surgeon, and some persons do so without any claims from 
qualification or otherwise, yet no one is recognized as belonging 
regularly to the profession, or can gain a respectable standing in 
the community, unless he has gone through a preparatory study 
and training, and received credentials from some authoritative 
body.* Such credentials are generally obtained from the Royal 



* This is one of the points in which the late act of Parliament has proved 
very useful. No one now can assume the title of surgeon or physician, who 
is not legally entitled to it. 






THE MEDICAL PROFESSION IN GREAT BRITAIN. 283 

College of Surgeons of London, whose diploma of membership, 
given after a certain specified course of instruction, and a suc- 
cessful examination by the College, is everywhere received as suffi- 
cient authority to practise, and is sought for by most of those who 
have respect for themselves, or seek the respect of the community. 
A higher position still is that of fellowship in the College, which 
implies more ample literary as well as professional attainment, and 
is conferred, after a satisfactory examination, upon candidates who 
can bring the requisite certificates of previous preparation, such as 
that they are twenty-five years of age, have a competent knowl- 
edge of the Creek, Latin, and French languages, and have been 
engaged for six years in the acquisition of professional knowledge, 
in recognized hospitals and schools of medicine, either in the 
British islands or abroad. 

I found a distinction made in England, in conversation, between 
the surgeons and consulting surgeons, though I could not discover 
any very definite line between the two sections of the profession. 
The consulting surgeons, however, appear to be those who aim at, 
or have obtained the highest position among their fellows, who 
leave to others the humble offices of the profession, and confine 
themselves to the giving of advice at their houses, to the perform- 
ance of operations, and to consultations. They are men of the 
highest attainment, respect, and influence in the communities in 
which they move, not unfrequently acquire considerable wealth, and 
in many instances have, like the more successful physicians, been 
honoured by knighthood or a baronetcy; the highest title which 
has ever yet been conferred on any member of any branch of the 
medical profession in Great Britain. Sir Astley Cooper, Sir Ben- 
jamin Collins Brodie, Mr. Travers, Mr. Stanley, and Mr. Liston 
are, or were, examples of this higher grade of surgeons. Mr. 
Norman, an eminent surgeon of Bath, and at the time mayor of 
that city, presided over the late annual meeting of the Provincial 



284 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

Medical Association, though numerous physicians, and some of 
them of high standing, were present. In short, I could not dis- 
cover that any marked distinction in social standing existed be- 
tween the physicians and consulting surgeons. Both are, I think, 
generally deemed much superior, on the average, to the lower 
grade of surgeons, and to the general practitioners. 

This last class will next engage our attention. It is by far the 
most numerous, and, if I am not much mistaken, is destined to 
play an important part in the future medical history of the coun- 
try. It took root in the once humble and despised apothecary, 
gradually grew upon the wants of the community, and has at last 
attained an overshadowing magnitude, which, though each indi- 
vidual branchlet may be of little significance, will probably in time, 
by its very mass, shut out the sunshine of public patronage from 
the hitherto more elevated classes, and cause them finally to wither 
in its shade. The original and proper business of the apothecary 
was no doubt to prepare and vend medicines; and this it ought 
still to have continued to be. In the United States, he remains 
what he originally was; and the consequence has been, that, by a 
concentration of time and abilities upon his own pursuit, he has 
elevated pharmacy from the rank of a mere trade to the dignity of 
a profession, and increased in a corresponding degree his own per- 
sonal respectability. It was otherwise in England. There, the 
apothecary, though he continued to prepare and sell drugs, su- 
peradded the practice of the different branches of the medical 
profession to the pharmaceutical, which thus became secondary 
in his own estimation and that of the public. Without becom- 
ing a good medical practitioner, he ceased to be a good pharma- 
ceutist; and the name of apothecary came at length to signify a 
mongrel compound of doctor, man-midwife, surgeon, and drug 
vender; a true jack of all trades and master of none; willing to 
play second part to the regular physician, and, though used by 






THE MEDICAL PROFESSION IN GREAT BRITAIN. 285 

the public, yet looked on by them with a sort of good-natured 
contempt.* 

It is not difficult to account for the different results in the two 
countries. With us, the practice of medicine, if not quite free, was 
trammelled with very few restrictions, and those by no means 
onerous ; so that it was easy for any one possessing moderate 
means to enter the profession, the ranks of which were thus kept 
filled up to the wants of the country; while competition placed 
the fees upon a level with the general means of the public. All 
the avenues to practice being occupied by those regularly trained 
to the pursuit, the apothecary had no opportunity or temptation 
to step over the legitimate bounds of his profession into the empty 
places of medicine. In England, on the contrary, the regularly 
educated physicians were comparatively few; and these, enjoying 
a kind of monopoly, were enabled to maintain prices at such a 
point, as to place their services beyond the means of persons in ( 
low or moderate circumstances. The poorer people, unable to 
pay for instructed advice, turned to the apothecary, who, as a 
vender and preparer of medicines, was naturally supposed to know 
something of their uses. He thus became the adviser and attend- 
ant of the lower classes ; and even those of the upper ranks gradu- 
ally began to employ him, first as a subordinate auxiliary to the 
physician, and at length as his substitute in mild cases, and the 
incipient stage of those of a severer character. Not being per- 
mitted to charge for his advice or his visits, he naturally sought 
to indemnify himself for his loss of time by an increased sale of 
his medicines ; and was tempted into various irregular modes of 



* It will be readily perceived by the context, that this sentence was in- 
tended to apply to the apothecaries as they formerly were. Their standing, 
at the time of my visit, was much more elevated; and, under the name of 
general practitioners, they constitute, upon the whole, a highly respectable 
branch of the profession. 



280 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

attaining this end, among which were excessive medication, the 
adaptation of the prescription to the pecuniary advantage of the 
prescriber rather than to the real wants of the patient, and a sys- 
tem of monstrous overcharging. I have been informed that it was 
formerly not uncommon for the apothecary to put up a dose of 
salts, worth two or three pennies, in half a dozen or a dozen 
potions, to be taken at intervals of an hour or two, each at the 
cost of a shilling. 

Conscience, and a proper sense of his interests, combined to in- 
duce the apothecary to render himself fitted, so far as possible, to 
the new office which had been in some measure forced upon him. 
He sought, therefore, in the hospitals and schools, and by a course 
of study, a competent knowledge of disease, and the recognized 
modes of treating it. Some attained great skill and reputation, 
and even raised themselves to the rank of regular physicians. 
Many, however, remained in contented inferiority or ignorance ; 
and the general standard of medical attainment among them was 
certainly not very elevated. The London Society of Apothecaries, 
who held the exclusive right, under the law, to grant licenses to 
practise their art, were by no means strict in their medical requisi- 
tions. The great majority of the people of England appeared to 
be doomed to intrust their health and lives to the chances of in- 
competent advice. But a new era has opened; great advances 
have already been made towards a better condition of things ; and, 
on looking down the long vista of futurity, we may see the prospect 
gradually widening and improving for this branch of the medical 
profession, and that portion of the public intrusted to them. 
Formerly, though the practice of medicine had been grafted on 
pharmacy, the latter continued to be the main object of solicitude, 
as it was the chief source of profit. Gradually the medical branch 
has acquired increased vigour, growing upon the nourishment that 
was thrown into it at the expense of the parent stem, until at 









THE MEDICAL PROFESSION IN GREAT BRITAIN. 281 

length it has expanded into a luxuriance which almost conceals 
the latter from view. The Society of Apothecaries established a 
higher grade of medical qualification for their licentiates, and sus- 
tained that grade by more rigid examinations. The education 
now demanded of the apothecary, before he can obtain permission 
to practise, is of a character quite equal to the requisitions of our 
own schools. Independently of five years' apprenticeship, which 
is considered requisite for his due pharmaceutical accomplishment, 
he must be twenty-one years old, have attended three courses of 
winter and two of summer lectures in some recognized school, and 
at least a year in some recognized hospital containing one hundred 
beds. Of the different branches of medicine, surgery alone is 
omitted from the schedule of studies. The apothecary, though a 
medical practitioner, is not necessarily a surgeon. But most of 
those who enter into this division of the profession, qualify them- 
selves also, as I was informed, for the practice of surgery, and 
become members, after due examination, of the College of Sur- 
geons of London. They thus lay themselves out for the practice 
of every branch of our art, exactly as the country physician in the 
United States; and, in correspondence with this position, they 
are beginning to throw aside the title of apothecary, and to assume 
that of general practitioners. Until recently they were allowed 
to charge only for medicines; the advice and attendance being 
thrown into the bargain. At present, according to the decision of 
the courts of law, they can charge for both ; and one great and 
most absurd evil has thus been corrected. The English general 
practitioners are now almost precisely upon a footing with the 
greater number of physicians in the United States, diifering simply 
in the circumstances, that they do not take the degree of doctor 
of medicine, and, in most instances, continue to unite the business 
of the retail druggist with that of the physician. They universally 
make lower charges than the usual fee of the physician in Eng- 



288 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

land, receiving, I believe, generally, from those who can afford it, 
live shillings instead of a guinea for each visit. They enjoy the 
advantage, also, if it can be considered one, of having a legal claim 
for compensation for their services ; and, as with us, they render 
their bills at stated periods, instead of receiving their fee in hand. 
It is easy to foresee that, with increasing competence, and a still 
more enlarged instruction, they must raise themselves in time to 
be the almost exclusive medical practitioners of the land ; for low 
prices, with equal qualifications, will in the long run invariably 
carry the day. The very wealthy, and the high aristocracy, may 
long continue to cherish the distinction of a physician at a guinea 
a visit ; but even they will, I think, in time, come into the five 
shilling system, when they learn that the great point of health can 
be equally well secured. But, before this end arrives, a great 
change is yet to take place in the plans of the general practitioner. 
It will be necessary for him to devote an exclusive attention to the 
medical department of his profession, and to cut loose from the 
pharmaceutical, which must be abandoned to the chemist and 
druggist, or in other words, the legitimate apothecary. 

Were time allowed me, it would be easy to point out the evils 
which flow from the combination of these two pursuits in one. 
As it is, I must content myself with a hasty sketch of them. They 
who are but superficially acquainted with the various qualifications 
required in the practitioners of medicine and pharmacy, know well 
that either one of them is sufficient to engross all the time and 
powers of a single individual; and that he who undertakes to 
unite them must, as a general rule, do so at the expense of profi- 
ciency in one, or the other, or in both. This alone is an all-suffi- 
cient reason why they should be separated. But there are others. 
The medical practitioner who prepares and dispenses medicine is 
constantly exposed to the temptation of over-medication if he 
charge for his medicines, of under-medication if he make no 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 289 

charge ; and if, in his capacity of apothecary, he be called on to 
put up the prescriptions of others, he is again tempted to an un- 
due interference with the physician, by undervaluing whose skill 
he is indirectly raising his own in the estimation of the patient, 
and paving the way for an extension of his practice. The majority 
may resist these temptations ; but some undoubtedly yield to them, 
and thus affix a stigma to the whole body, which has a tendency 
to indispose young men of the highest qualifications from joining 
it, and consequently lowers somewhat not only its general reputa- 
tion, but its real efficiency. The general practitioners of England 
can never place themselves on a level with the physicians and 
higher grade of surgeons, until they shall have effected the separa- 
tion alluded to ; and we shall do well in this country to take 
warning from English experience, and scrupulously continue to 
keep the two professions distinct. In relation to practitioners in 
thinly peopled neighbourhoods, where apothecaries' shops are not 
accessible, it is necessary that the physician should himself dis- 
pense medicines to his patients ; but it is not necessary that he 
should make a business of their preparation and sale, and thus 
load himself with the burdens and responsibilities of another pro- 
fession. 

From what has been said you will have inferred that the organ- 
ization of the profession in England is very complex. It is even 
more so than I have described it, in consequence of the varying 
action of different bodies, having or professing to have peculiar 
legal powers, or at least exercising by prescription peculiar influ- 
ences which have almost the force of law. Thus, connected with 
the Royal College of Physicians are two if not three classes of 
practitioners; with the Royal College of Surgeons, two; with the 
Society of Apothecaries, a third ; while, in the instance of new 
regulations in any of the institutions, there is necessarily one class 
of those in existence before their adoption, and another of those 

19 



200 THE MEDICAL PROFESSION IN GREAT BRITAIX. 

who enter the profession afterwards. The degree, moreover, of 
different institutions is of different weight, that of Oxford and 
Cambridge being perhaps more highly esteemed than that of 
Edinburgh or Glasgow, or of the foreign universities. In fact, 
upon making inquiry of some of my medical friends in England, I 
found that even there all the entangled relations of the different 
sections of practitioners were not by any means universally under- 
stood. From this cause it has happened that the movements in 
the profession, which a sense of its imperfect organization has 
occasioned, and the extent of which indicates a general dissatisfac- 
tion and restlessness under the present system or want of system, 
have hitherto been productive of no very important results. The 
lawmakers have shown a disposition to aid the profession in work- 
ing its way out of these intricacies ; but a movement made in any 
one direction is apt to be met by the remonstrances of some op- 
posing privilege, interest, or prejudice ; and legislative interference 
appears to have been postponed until some plan can be presented, 
which shall unite the suffrages of the great body of those con- 
cerned. I cannot but think that the sagacity and judgment so 
characteristic of the English will ere long be brought to bear on 
this confused subject, and that measures will be devised calculated 
to bring about harmony if not perfect unity in the profession ; so 
that the struggle as to what peculiar interest shall be best pro- 
moted or defended, will give way to an emulous rivalry in further- 
ing the general good. There should be one education and one 
grade of honour common to all; and everything else should be 
left to individual effort. Some, as at present, would addict them- 
selves to medicine, some to surgery, some to midwifery, etc.; and 
many would combine the three branches together. The more 
special practitioners might be slower of success, but would in the 
end acquire greater skill and reputation, and consequently greater 
emolument ; and there would be an ample field for the gratifica- 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 291 

tion of an honourable ambition on the broad basis of equal rights 
and privileges to all.* 

The remarks hitherto made have had reference chiefly to the 
organization of the profession ; but the view would be very incom- 
plete in your eyes, were I not to present you some account of the 
plan of medical education, and the qualifications demanded of the 
candidate for the medical diploma, or in other words, for the certifi- 
cate of qualification to practice. You will be surprised to learn 
that none of the proper medical schools in England, and none of 
the literary institutions with which they are directly connected, 
have the power either of conferring degrees, or of giving a license. 
The only graduating bodies are the Universities of Oxford, Cam- 
bridge, and London. The first two grant medical honours to those 
exclusively who have completed a course of academic study under 
their own supervision, unless perhaps the graduates of the Dublin 
Univerity may constitute an exception; the last extends them to 
all who can present the requisite credentials, and undergo the 
requisite examinations, no matter in what school or schools their 
medical education may have been conducted, provided only that 
the school be one recognized by the University, and, of the four 
years of scholastic attendance required, one year at least shall have 
been in connection with one or more of the schools of the United 
Kingdom. Attached to the Universities of Oxford and Cambridge 
there are professorships in the medical sciences, and, in the latter, 
courses of instruction are given ; but in neither is there a complete 
school. The University of London has not even the shadow of a 
school attached to it ; for the University College of London, whose 
medical class is I believe the largest in England, has no more con- 

* I scarcely^need repeat that, since this lecture was delivered, an act of 
Parliament has been obtained, -which, though it is not all that could be 
■wished, has enabled the profession to organize itself, and promises to lead 
to very useful results. 



292 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

nection with the University of London, notwithstanding the simi- 
larity of name, than any of the other respectable schools upon the 
island. The University is merely an examining and degree-con- 
ferring body, established by government in order that dissenters 
might be enabled to obtain academic and medical honours ; the 
graduates of Oxford and Cambridge being required, I believe, to 
profess adhesion to the national church. 

The schools are generally established in association with hos- 
pitals ; the prescribing physicians and surgeons of these institutions 
uniting to get up courses of instruction in the different branches of 
medicine and surgery ; and so necessary is the hospital connection 
deemed, that, when independent schools are instituted, they en- 
deavour to set on foot an infirmary, to be under the charge of the 
teachers, as in the cases of the King's College, and the University 
College in London. Had I time, I could easily demonstrate, to 
your satisfaction, that this plan of forming schools as subsidiary 
to the hospitals can never be permanently and greatly successful. 
The chief objection to it is that the officers are appointed, not in 
reference to their qualifications as teachers, but for the practical 
charge of the infirmary. It may accidentally happen that one or 
more of them may possess high teaching powers ; but a succession 
of such happy accidents can scarcely be expected ; and the reputa- 
tion of the school must be temporary. No great school of the kind 
has maintained a permanent existence in England ; no one in fact 
has ever risen into the eminence which institutions have attained, 
based upon the principle, that peculiar qualification for the duties 
to be performed should be the ground of appointment. The most 
successful school in London has been that of the University Col- 
lege, in which the professors are chosen for their professorial abili- 
ties, and not for their fitness, either from favour or qualification, for 
the office of physician or surgeon to an hospital. 

Schools are numerous both in London and the provinces. In 
the former, thirteen are recognized by the London University, in 






THE MEDICAL PROFESSION IN GREAT BRITAIN. 293 

the latter no less than sixteen, of which the most distinguished are 
those of Manchester and Birmingham. Many of these schools are 
imperfect ; but, as the requisition for graduation or a license is 
that the candidate shall have attended courses on certain subjects, 
for a certain length of time, he may receive his instruction, if he 
see fit, in several distinct schools, attending to one subject in one 
and to another in another; so that any deficiency in the arrange- 
ments of a school, as to the subjects taught, may be easily supplied. 
Most of the schools are very slenderly attended; many having 
classes of considerably less than fifty pupils, while the most flour- 
ishing seldom exceed two hundred, or two hundred and fifty. 

The population of England cannot support so large a propor- 
tionate number of practitioners as ours, in consequence of the vast 
excess of the poor, who never pay for medical aid. This class of 
the population can contribute to increase the number of prac- 
titioners, only in so far as the medical assistance yielded them is 
paid for out of the public purse; but the compensation thus given 
is so ridiculously insignificant, and the numbers of the poor whom 
it is expected that each practitioner employed for the purpose 
shall attend is so absurdly great, that but a small addition can 
be made to the aggregate number of medical men upon this score. 
The inadequacy of the compensation made by the public for at- 
tendance on the poor, is one of the most common and loudest com- 
plaints of the profession ; and I have heard the strongest terms of 
reproach lavished on the wretched parsimony, which exhausts and 
impoverishes the medical practitioner, while professing to pay him 
for his services. I remember being told that the practitioners em- 
ployed by the government, during the prevalence of the typhous 
epidemic, which has recently been desolating Ireland, were expected 
to expend their whole time, and more than all their energies, in 
visiting the destitute sick over wide tracts of country, for the miser- 
able pittance of five shillings a day ; scarcely sufficient to pay for 
their necessary horse-hire. Why, it may be asked, should they 



294 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

submit to be thus treated? The answer simply is, that, placed as 
they are in the midst of the perishing poor, they are compelled by 
the ordinary feelings of humanity to make every possible effort for 
their relief; and the government, with the spirit of a usurer prey- 
ing upon the struggles of the unfortunate, speculates upon their 
benevolence. The consequent exposure and hardships prove ex- 
tremely destructive to the practitioners thus employed ; and I 
heard one of the most eminent of the physicians of Ireland say, in 
the most mournful and touching accents, that one-fifteenth of all 
the medical men of that island had perished in the year 1847, 
chiefly of typhus fever. The evil is not so great in England ; but 
it is even there universally looked on by the profession as a most 
crying grievance, a piece of enormous injustice, which the public 
are called on by every principle of right, and every feeling of 
humanity, to rectify. 

If the whole number of students is small, that of the candidates 
for the degrees in the universities is incomparably less ; and I was 
astonished to learn that the University of London does not grad- 
uate more than ten or eleven annually. I was told that, in all 
London, there were probably at no time more than from eight 
hundred to a thousand students of medicine ; and of these but a 
small proportion is engaged in attendance at the same time upon 
all branches ; so that, divided among the thirteen recognized 
schools, the average class of each individual teacher must be small. 
I do not know that it is a legitimate matter of boasting; but the 
fact is certainly worthy of notice, that, while London, the metrop- 
olis of the world, with two millions of inhabitants, has little more 
than eight hundred medical pupils, Philadelphia, with only one- 
sixth of the population, counts her thousand or twelve hundred 
every winter. 

It maybe expected that I should detail the qualifications deemed 
essential for admission into the different classes of practitioners re- 
spectively ; but time is wanting, and I must be content with stating 



THE MEDICAL PROFESSION IN GREAT BRITAIN. 295 

that, in relation to preliminary education, length of study, amount 
of knowledge, and age of admission, the requisitions for the highest 
class are much greater than with us, while, for those of a lower 
grade, they are about the same. Thus, four years of study are de- 
manded by the University of London as preliminary to the degree 
of Bachelor, six years to that of Doctor of Medicine ; the Royal 
College of Physicians and that of Surgeons, require, the former five 
and the latter four years ; and the Apothecaries' Society exacts of 
every candidate for their license, which constitutes the only legal 
authority of the general practitioner, besides an apprenticeship of 
five years with an apothecary, an attendance upon not less than 
three winter and two summer sessions of lectures. 

Notwithstanding these higher requisitions upon paper, were I 
called on for an opinion as to the relative qualifications of the 
medical men in England and the United States, though confessedly 
not possessed of all the means of forming an accurate judgment, I 
should say, from what I have observed, that, if the higher grades 
of English physicians are superior in education to ours, the case is 
reversed in relation to the great mass of practitioners. The main 
cause of this superiority on our part, admitting it to exist, is prob- 
ably that the American practitioner reads much more, after the 
nominal completion of his studies, than the English, of which one 
of the strongest proofs is the comparatively small editions of medi- 
cal books sold in England. Their own best works are more read 
in the United States than at home. My friends in England ap- 
peared to be astonished when informed of the number of medical 
books sold in the United States. Perhaps one cause of this differ- 
ence may be, that the great body of English practitioners, being 
apothecaries, have their time too much engrossed by the pursuit of 
two distinct branches of business to allow much of it to be devoted 
to further study. 

It remains only that I should give a hasty sketch of the organ- 
ization of the profession in other parts of the United Kingdom. 



296 THE MEDICAL PROFESSION IN GREAT BRITAIN. 

In Ireland, it is almost an exact copy of that existing in England : 
the same classes of practitioners; the same licensing and graduat- 
ing authorities; the same system of medical instruction. There 
arc in Ireland, as in England, physicians, surgeons, and apothe- 
caries. Dublin has its King and Queen's College of Physicians, 
its Royal College of Surgeons, and its Apothecaries' Hall, closely 
analogous in their constitution and privileges to the corresponding 
institutions in London. There is also the Dublin University or 
Trinity College, which confers degrees in medicine; but differs 
from the English universities in having a completely organized 
school of medicine connected immediately with it ; in this respect, 
resembling the Scotch universities and our own. But there are 
numerous other schools in Dublin, private or connected with the 
hospitals, in which the large classes of the surgeons and apothe- 
caries mostly receive their education ; but they neither confer de- 
grees, nor give any license to practise. Most of the students who 
aim at the medical degree resort, or until recently have resorted, 
to the Universities of Edinburgh and Glasgow. I was told that 
the class of apothecaries or general practitioners are not equal in 
attainment to the English ; as the Dublin Apothecaries 1 Hall is 
less rigid in its examinations, and less exacting in its requisitions 
than the analogous society of London. The two degrees of Bache- 
lor and Doctor of Medicine are conferred by the Dublin Univer- 
sity, the former being regarded as a sufficient license to practise, 
and the latter merely as an honour. 

In relation to Scotland, I confess that I have less precise inform- 
ation than of the two other sections of the kingdom. My journey 
through North Britain was so rapid, and my attention so much 
engrossed by other objects, that I failed to make full inquiries. 
But, from what I did see and hear, and from the comparative 
facility with which the degree of Doctor of Medicine, hitherto, I 
believe, the only one conferred by the Scottish schools, may be ob- 
tained, I have inferred, that physicians, or, in other words, grad- 






THE MEDICAL PROFESSION IN GREAT BRITAIN. 297 

uates in medicine, are much more numerous proportionably in this 
than in the southern section of the island, or in Ireland ; and that, 
as with us, they perform all the offices of the profession; some 
directing a more exclusive attention to the pure practice of medi- 
cine, others to surgery, and others again to obstetrics. There is, 
however, a distinct body of surgeons, who practise under the 
license of the Edinburgh College of Surgeons, the Glasgow Faculty 
of Physicians and Surgeons, or some similar institution, without 
having obtained a degree. I heard of no class precisely analogous 
to the apothecaries or general practitioners of England. 

The bodies having the right to confer the degree of Doctor of 
Medicine in Scotland, are the Universities of Edinburgh, Glasgow, 
Aberdeen, and St. Andrews, and the King's College of Aberdeen. 
Of these, the Universities of Edinburgh, Glasgow, and Aberdeen, 
have medical schools connected with them, exactly as the Univer- 
sity of Pennsylvania. All profess to require four years of attend- 
ance upon medical lectures ; and most of the courses of lectures 
are required to be of six months' duration, which is the case also 
in the English schools. Besides these graduating institutions, there 
are three which have the power of licensing ; namely, the Royal 
College of Physicians and the Royal College of Surgeons of Edin- 
burgh, and the Faculty of Physicians and Surgeons of Glasgow. 
There is a respectable medical school in Glasgow, connected with 
the institution called commonly, from its founder, the Anderson 
University, which has not, however, I believe, any legal collegiate 
powers. 

The observations, already incidentally made, will spare me the 
necessity of speaking further of the general character of the medi- 
cal profession in the British Islands. Upon the whole, I presume, 
their relative social standing is equal or superior to that of the 
profession in any other country in Europe, though inferior to that 
which is enjoyed in the United States, where, I am proud to say, 
the medical men as a body maintain a position with the highest, 



298 THE .MEDICAL PROFESSION IN GREAT BRITAIN. 

whether we take, as a measure of elevation, extent of attainment, 
sentiments of honour and of humanity, cultivation of manner, or 
the respect of the community. 

There is, however, one point of which I would speak before I 
close. I wish to call your attention emphatically to the hospitable 
qualities of the medical practitioners of the United Kingdom, and 
especially to their kindly disposition towards their professional 
brethren in this country. Wherever I went, throughout the isl- 
ands, it was only requisite that I should be known as a physician 
from the United States, of ordinary repute at home, to secure me 
the kindest reception ; and the want of time often compelled me to 
forego hospitalities that were urged upon me. I may be allowed, 
perhaps, to mention one instance in proof of what I have stated. 
Arriving towards the close of the day at one of the chief cities of 
England, I left my own card with another of introduction at the 
door of a physician of the place. After dark, he called upon me, 
stating that he had come immediately after receiving my card; 
and, having been told that we should depart on the following 
morning, insisted upon taking me at once over the town, and 
showing me as much of it as could be seen by the light of a beauti- 
ful moon, which had risen. I agreed to the proposal, and together 
we wandered through the streets and lanes, and about the walls of 
the city till it was nearly midnight. In the course of our peregrin- 
ations, I observed that remarkable respect was everywhere paid to 
my companion by the police ; and, before returning to my quarters 
in the hotel, learned that I had been under the guidance of the 
mayor of the city. This act of extraordinary courtesy, with others 
which greatly facilitated my objects in travelling through that sec- 
tion of the country, I shall always bear in very pleasing remem- 
brance. 

All of you know of the meeting of the American Medical Asso- 
ciation at Baltimore in May last. At that meeting, a delegation 
was appointed to represent the body in the British Provincial 






THE MEDICAL PROFESSION IN GREAT BRITAIN. 299 

Medical Association which was to assemble at Bath in August. 
Among others, I myself, being in England at the time, was named 
upon the delegation ; and, wishing to give effect to the intentions 
of the Association, I made arrangements, though at the expense 
of my previous plans, to be present at the meeting. My reception 
was, beyond all expectation, kindly and respectful. The creden- 
tials were read ; resolutions of the most nattering character were 
passed unanimously; and the whole meeting rose to greet the 
messenger of good-will and brotherly sentiments from beyond the 
Atlantic. I was of course gratified; I can hardly express how 
highly gratified ; not so much at the honour done to me, as to my 
country through me. These expressions and evidences of mutual 
good-will are of the highest national importance. A reciprocity 
of kindly feeling can scarcely actuate distinct masses of intelligent 
men, such as compose the medical profession in England and Ame- 
rica, without radiating more or less through their respective com- 
munities, and thus serving as a bond of peace and amity between 
two nations, whose mutual good-will is essential to the prosperity 
and happiness of both, and which, if united in the prosecution of 
the great object of human advancement, will exercise the most 
happy influence over the destinies of the whole earth. Let me 
urge upon you, gentlemen, to do all that lies in your power, by the 
cultivation of this friendly spirit towards your British brethren, to 
further so desirable a consummation. 



LECTURE II. 



DELIVERED OCTOBER 14th, 1853. 



The Medical Profession on the Continent of Europe. 

Gentlemen : — 

Most of you are probably aware that I have been spending the 
season just passed in a tour upon the Continent of Europe. From 
the relations subsisting between us, you may very reasonably 
expect from me some fruit of this journey, that may be useful to 
you in your capacity of students of medicine. You will not, there- 
fore, I trust, ascribe it to presumption on my part, or an over- 
weening disposition to obtrude myself on your notice, if I attempt 
to answer such an expectation by offering to you some of the ob- 
servations and reflections, of a medical character, which I have 
had occasion to make in the course of the journey. Should you 
discover signs of haste and carelessness in my communication, I 
must beg of you to remember that it has been prepared in the 
course of a few days, amidst crowded occupations, and imme- 
diately upon returning from a long absence, and to make all due 
allowances. 

You will, I hope, excuse me, if, in the first place, I give you a 

very brief sketch of my route, so that you may know what have 

been my opportunities of observation, and thus be able to estimate 

more accurately than you otherwise could do the value of my 

(300) 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 301 

statements and opinions. It is proper to say that I was accom- 
panied throughout the journey by my friend, Professor Franklin 
Bache, of the Jefferson School, and have consequently had the 
advantage of an excellent auxiliary judgment, in considering the 
various facts that came under our joint notice. 

Having made a rapid passage to Liverpool, and remained a 
short time in London, we reached Paris early in May, and, about 
the middle of the month, left that city for the south of France. 
Upon our route in this direction, we visited Bordeaux, Montpel- 
lier, and Marseilles, and afterwards, entering the dominions of the 
King of Sardinia, passed through Nice, Genoa, and Turin, and 
crossed Mont Cenis, then covered at its top with snow, though so 
late as the seventh of June. I would here incidentally remark that, 
during almost the whole of our journey, the weather was unusually 
cool, and at the very time that, here at home, you were scorching 
with the intensity of the heat, we found fires in the evening neces- 
sary to comfort, on the shores of the Mediterranean. I was told 
at Nice that the coldness of the weather was almost unprecedented 
at that place. The chief interest of this fact is the evidence it 
affords, so far as it goes, of a compensating influence in the distri- 
bution of terrestrial temperature, by which what is lost by one 
part of the earth is gained by another; so that the invalid may in- 
dulge the hope of escaping an uncongenial season in his own coun- 
try by a voyage over the ocean, now reduced to a mere trifle, in 
point either of time or trouble. From Savoy we entered Switzer- 
land, and, having visited Geneva, Berne, Zurich, and other noted 
towns of that glorious region, crossed the Lake of Constance, and 
prosecuted our journey through Augsburg, Munich, Saltzburg, 
etc., to the Austrian capital. From Yienna, where we spent a 
few busy days, we proceeded northward through Bohemia, Saxony, 
and Prussia, to the shores of the Baltic, giving, as we passed, a 
short time to the cities of Prague, Dresden, and Berlin. Descend- 
ing the Oder from Stettin, we steamed over the Baltic to Stock- 



302 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

holm, visited the famous Upsala, once the capital of Sweden, and 
long the site of its most famous school, then returned to Stettin, 
and took a fresh start thence, up the Baltic and Gulf of Finland, 
to St. Petersburg. 

An interesting medical fact, in connection with this part of our 
tour, was that, notwithstanding the existence of quarantine regu- 
lations, enforced with extreme strictness, between Sweden and all 
the ports of the Baltic where cholera was known to have appeared, 
the disease, nevertheless, entered Stockholm, and had begun to 
spread with considerable violence before we left the north of 
Europe. Sweden is, I believe, at present the only country in 
Europe where quarantine laws are enforced against the disease; 
as experience has shown that they are altogether futile for any 
good result, while they prove of great inconvenience to the travel- 
ler, and the source of much commercial loss.* 

Another medical fact of some interest is the prevalence of a 
mild form of intermittent fever in the neighbourhood of Stock- 
holm, in the latter part of summer and beginning of autumn. I 
was much surprised at this ; for, though the country is full of lakes 
and inlets from the sea, and shows upon the map almost as much 
of water as of land, yet the region is, I believe, wholly granitic, 
and the latitude is considerably beyond the highest point at which 
marsh miasmata are usually supposed to be generated. 

But to return to my narrative, which was broken in upon by 
these reminiscences, I will merely further state that, having made 
a short visit to Moscow, we left Russia, and returned southward 
through Germany, Holland, and Belgium, to Paris, visiting by the 
way, among other cities, those of Frankfort-on-the-Main, Cologne, 
Amsterdam, the Hague, Leyden, Antwerp, and Brussels. From 
Paris, we came homeward by the route of London and Liverpool, 



* I have been informed that, since the period of our visit, the quarantine 
laws, so far as they related to cholera, have been abolished. 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 303 

and, after a stormy passage of nearly twelve days, reached New 
York on the second instant, rejoiced once again to be in our own 
land, which all that we had seen abroad had but taught us to love 
and esteem the more. 

During the journey, of which I have thus given a very brief 
sketch, we availed ourselves of every offered opportunity of ex- 
amining the medical schools and hospitals, and making ourselves 
acquainted with the state of the profession in the several countries 
visited. I owe it to the medical men whom we met to state that, 
almost without exception, they treated us with courtesy and even 
kindness, and took apparent pleasure in facilitating our inquiries. 

The great rapidity of our progress, and the numerous objects of 
interest unconnected with medicine, which met us at every step, 
and required a portion of our attention, precluded a minute inves- 
tigation ; and it is, therefore, general views rather than detailed 
statement, or elaborate description, which I have to offer. Fortu- 
nately this corresponds with the requisitions of the present occa- 
sion, wherein time is not allowed, and attention could scarcely be 
commanded for minute and copious details. 

In a former address to the medical class, which they did me the 
honour to publish, I presented some views of the state of the medi- 
cal profession in Great Britain, which render further reference to 
that subject unnecessary now. The observations I am at present 
about to make will relate to the continent, and to that portion of 
it only through which our route lay; the Spanish, Italian, and 
Grecian Peninsulas, and the European dominions of the Sultan, 
not being included. 

The first and most important element in the consideration of the 
subject is medical education. No course of argument is required 
to show that this must lie at the foundation of the professional 
character in every country; and that, according as it is well or ill 
conducted, and to the special manner in which it is conducted, 
must, in great measure, be the condition of the profession itself, in 



304 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

regard not only to its general efficiency and repute, but also to 
its peculiar and characteristic traits. 

Throughout all those parts of Europe referred to, medical edu- 
cation is carried on essentially in the schools. These are never, so 
far as I had the opportunity of noticing, independent establish- 
ments, like many existing in our own country, but are always con- 
nected with some great general school or university, from which 
the honours emanate, after compliance on the part of the candidate 
with certain regulations, among which the most important are a 
particular duration of study, and examinations at fixed and fre- 
quently recurring periods. 

The laws of the country have an important bearing upon medi- 
cal education. In general, no person is allowed to practise, who 
has not obtained a license or degree from a university or other 
analogous institution. This gives great authority to the schools, 
enabling them to make and enforce regulations, and exact an 
amount of attainment on the part of the candidate, which they 
could do in no other way so efficiently. Even with this advan- 
tage, however, they do not always succeed in making good and 
accomplished practitioners. Competition, so useful when properly 
restrained and regulated, becomes here, as in almost everything 
else, when left to an unrestricted course, the cause of some evils. 
In the large states, where one will, whether that of a despot or 
of a constitutional authority, controls all things relating to educa- 
tion, it is comparatively easy to proportion the number and extent 
of the schools to the wants of the community ; but the case is far 
otherwise when many small independent governments exist, each 
with the power to establish as many schools as it may see fit, but 
often not possessed of the resources and materials requisite for the 
support of one. In instances of this kind, the school must depend 
for its success upon a reputation extended beyond the limits of the 
state in which it has been established, and upon the inducements 
it can offer to students from all quarters. Now, such is the condi- 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 305 

tion of things in Germany, where a large number of small sov- 
ereignties exist, each ambitious to distinguish itself by its scholastic 
institutions, and greedy of the advantages of various kinds which 
these institutions, when successful, yield to them. So far as the 
competition is limited to the earning of a reputation for efficiency 
of system, or excellence of instruction, it is productive only of 
good; but, unfortunately, all cannot win for themselves such a 
position, nor, having gained it through the extraordinary efforts of 
gifted men, can they retain it when no longer supported by the 
same talent and energy. Under these circumstances, the tempta- 
tion is sometimes irresistible to compensate for deficiency of merit 
by a reduction of the standard of qualification, and, if the enter- 
prising and highly gifted cannot be attracted, at least to secure 
the economical advantages by filling the rooms with materials of a 
lower order, and sending forth into the world, with the stamp of 
the school, unqualified men, who are more able or willing to pay 
for their honours than to earn them. I was informed, in Russia, 
that throngs of the inferior graduates of some of the German 
schools make their way into that country, and that it had become 
necessary there, though, from the vast extent and population of the 
empire, there is an almost unlimited field for the exercise of com- 
petent medical abilities, to guard the public against this sort of 
regular charlatanism, by a rigid system of examinations, to which 
every one must submit, before he can be permitted to practise. 

The long duration of the term of study in the European schools 
is one of their important characteristics. So far as my informa- 
tion extends, this varies from four to six years, being in no instance 
shorter than the former of those periods, which, as all of you know, 
is one year longer than the longest with us. This is certainly an 
advantage which they possess over us ; and it might be inferred, 
with apparent reason, that, supposing the capacity and industry to 
be equal, the result must be a great superiority of professional 
qualification in the European graduate. Yet, when examined in 

20 



300 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

all its bearings, the longer period will not be found to possess all 
the practical advantages which, on a superficial view, might be 
ascribed to it. The system of instruction in the schools of Europe 
embraces, not only the studies having a close and essential connec- 
tion with medicine, but also various accessory sciences, which, 
though creditable accomplishments, and to a certain extent useful 
to the physician, have little or no direct influence either in im- 
proving our knowledge of disease, or rendering us better able to 
treat it successfully. The various branches of natural history, in- 
cluded under the titles of mineralogy, botany, and zoology, are of 
this kind. The excess of the European period of pupilage over 
ours is, in a considerable degree, occupied with such studies as 
these; and thus the real difference, so far as concerns strict medi- 
cal science, is less than at first sight it might seem to be. Upon 
the whole, probably, the tendency of the European plan in this 
respect is to produce graduates of higher scientific attainments, 
and probably of more thorough anatomico-pathological knowledge 
than ours, but little, if at all, superior as practical physicians. 

Another highly important feature of the European system is the 
succession of studies, with periodical examinations. The whole 
period of instruction is divided into annual or semi-annual terms, 
to each of which are ascribed certain branches of study ; and, be- 
fore advancing from one of these terms to the next, it is required 
that the pupil should submit to an examination as a test of his 
proficiency. This is clearly the proper method of teaching. The 
pupil begins at the foundation, and regularly proceeds with the 
structure of knowledge, until the whole original design is com- 
pleted. He does not, as is too frequently the case with us, at- 
tempt to carry on all parts of the edifice at the same time, or, as 
we sometimes do, begin at the top and build downwards. The 
study is thus rendered at once more easy and more fruitful. In 
the United States we pursue to a certain extent the same plan, 
when the student resides for the whole period of instruction in the 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 30T 

near vicinity of the schools. But coming, as most of you do, from 
a distance, aud spending but the half of each year in the schools, 
it would not be practicable to carry the plan into full effect, unless 
by a prolongation of study, and an amount of pecuniary outlay, 
which would be extremely inconvenient, and for many next to im- 
possible. In a considerable degree, this inconvenience may be 
obviated by the system of private office instruction established in 
this country, by means of which the pupil may be carried through 
a regular course of studies and examinations upon the elementary 
branches in their due succession, and may thus come to the lec- 
tures, prepared to understand and avail himself of what he may 
hear upon all the branches. It is true that this, even when well 
carried out, is but a partial substitute for the plan of regular and 
successive attendance upon public instruction from the beginning ; 
but it is the best that can be adopted for the great mass in the 
circumstances of our country ; and it is very important that private 
teachers everywhere should feel themselves under a conscientious 
obligation to give it full effect, by a proper guidance of the studies 
of their pupils, and frequent and thorough investigations into their 
proficiency. 

Still another characteristic of the European schools is the im- 
portance-attached to clinical instruction. Instead of being, as 
with us, a subordinate and, as it were, incidental branch, generally 
more or less defective, and sometimes altogether neglected, it is 
there recognized as indispensable, and, indeed, constitutes one of 
the most prominent features in the system of the schools. On this 
account, hospitals are considered as essential accessories; and in 
all Europe I did not see a single medical school, which had not 
one or more of these establishments associated with it. In some 
instances, indeed, the hospital is the chief part of the school, and 
the only practical lectures given, whether in medicine or surgery, 
are within its walls. In general, however, it is subordinate, and 
made by legal arrangements dependent on the scholastic institu- 



308 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

tion. I need not dwell on the vast advantages of this method of 
teaching medicine. The importance of demonstration in lectures 
upon all medical subjects is now almost universally admitted. It 
is the main point in which a system of oral instruction is superior 
to one of mere private reading or study ; and surely no mode of 
demonstrating disease is so effective as that of exhibiting the 
patient himself in all the different phases of his disorder, and in all 
the modifications of his condition produced by treatment. Every 
method of demonstration is more or less useful ; and hence, what 
have been erroneously called school-clinics, which have for some 
years past been in such great favour in this country, are not with- 
out their advantages. But it would be a great mistake to consider 
them as sufficient substitutes for hospital instruction. It is impos- 
sible by means of them, to demonstrate satisfactorily severe acute 
affections, the regular progress of disease from beginning to end, 
or the morbid anatomy of cases terminating in death. It is mainly 
in consequence of the number and easy accessibility of the hospi- 
tals, that Paris has gained its present enviable position as the 
great world-centre of medical instruction. In other respects, I 
could not discover that the student enjoyed better opportunities 
there than are offered to him in Philadelphia. In Paris, the hos- 
pitals not only serve the purpose of medical and surgical demon- 
stration, but afford also extraordinary facilities for the prosecution 
of practical anatomy, both normal and pathological. There were 
few thiugs in that magnificent city which more struck and inte- 
rested me than the establishment denominated " The Amphitheatre 
of the Hospitals." It consists of buildings admirably arranged 
for the purposes of post-mortem examination and anatomical dis- 
section, whither are brought all the unclaimed dead bodies from all 
the hospitals of the city, preparatory to interment. Students, who 
have been regularly enrolled in the "School of Medicine," have the 
privilege of gratuitous admission to these rooms, where to every 
class of five one body is given every ten days, as I was informed ; 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 309 

thus affording them ample opportunities not only for pathological 
investigation and for dissection, but also for surgical improvement 
by the frequent performance of operations on the dead subject. 
So complete are all the arrangements, that a small plot of ground, 
in the immediate neighbourhood of the dissecting apartments, has 
been planted with trees, and furnished with seats ; so that, in the 
summer, the student, when tired of his work, may seat himself 
under the shade, in the cool air, and, while enjoying his rest, may 
add the luxury of a cigar, if it please him. Imagine him to your- 
selves leaning backward in one chair, with his legs, more Ameri- 
cano, stretched out upon another, and, as he puffs forth the smoke 
from the corner of his mouth, watching its curling ascent with a 
placid air, that speaks volumes of interior contentment. I think, 
gentlemen, if you ever visit Paris for the purpose of professional 
improvement, you will not overlook the amphitheatre of the hos- 
pitals. 

I will take my leave of the subject of the hospitals for the pre- 
sent, by remarking that it is impossible to value them too highly 
as auxiliaries to a course of medical instruction; and what we 
most need in this country, is a more thorough union, or at least, a 
more hearty and full co-operation of these institutions with the 
schools. 

The plan of private medical tuition in vogue throughout the 
Union has a tendency, in some degree, to supply the want of hos- 
pital opportunities. The student, in the intervals between the 
courses of public instruction, may often see and even manage cases 
of disease under the guidance and oversight of his preceptor, and, 
if both perform their parts diligently and conscientiously, may gain 
much in the way of practical experience ; though an impartial judg- 
ment will still pronounce in favour of the hospitals, where disease 
may be seen in much greater variety than is possible in the prac- 
tice of any one man, and where, besides, the pupil has generally 



310 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

the advantage of instruction from men of experience, trained in 
the art of communicating knowledge by the bedside. 

I have before referred to the successive examinations in the 
European schools, each examination being as it were a sentinel 
placed at the door of admission into the several higher grades of 
study, and guarding them against intrusion from the incompetent 
pupil. I cannot, however, help believing that these examinations 
are in many instances not very strict, and are employed rather as 
implements of terror to alarm the idle or careless, than as real and 
effective tests of attainment. The same, however, cannot be justly 
said, as a general rule, of the final examination which is to deter- 
mine the fitness of the candidate for the license of the doctorate. 
This is usually performed in public, and invested with formalities 
which may even sometimes impress upon it a character of solem- 
nity. In most of the schools we visited, a large apartment is appro- 
priated to this special purpose, and is generally more elaborately 
furnished than any other public room in the building. Not unfre- 
quently its walls are hung with portraits of the deceased professors, 
perhaps from the origin of the school, who may be supposed to be 
looking down on the proceedings, prepared to frown upon any 
dereliction of duty, that may tend to lower the dignity of the school 
which they had founded or adorned. I remember well, at Ley den, 
having my attention especially engaged by the portrait of the 
famous Boerhaave, which hung with many others upon the wall, 
and both to myself and my companion recalled strongly the feat- 
ures of our great Franklin. In the medical school at St. Peters- 
burg, I was much pleased with a method which had been adopted 
to stimulate the student to extraordinary efforts. In the hall of 
examination, which is a magnificent apartment, a large marble 
tablet has been set into the wall, in a conspicuous place, with the 
names, graven in gilt letters, of those candidates who had most 
distinguished themselves from the foundation of the school. There 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 311 

was generally one name for each year; but in some years there 
were two, and in one at least none at all. 

Much importance is attached, in Europe, to the examinations. 
They are almost exclusively relied on as the test of fitness. The 
student, after having inscribed his name upon the catalogue of the 
school, is left to his own course. He may attend what lectures 
he pleases, or none at all ; but he must, in some way or another, 
qualify himself for answering the interrogatories that may be put 
to him, whether in the preparatory or the final investigation. This, 
I think, is a defect. A certain amount and character of attendance 
upon the means of instruction provided should always be required, 
without which, admission to the examinations should be refused. 
These are not always reliable criteria. The student may be for- 
tuitously examined on points with which he may happen to be 
familiar, though generally ignorant ; or he may be drilled by per- 
sons who have made themselves acquainted with the routine of 
questions into which the several examiners are apt to fall, and may 
thus be enabled to answer tolerably with little real knowledge ; or, 
finally, the examiners may, from various interested motives, con- 
trive that the candidate shall be successful, however incompetent. 
If attendance upon lectures be exacted preliminarily to the exam- 
ination, the student will at least have been in the way of acquiring 
knowledge; and some additional guarantee of fitness is thus ob- 
tained. 

In some, if not in most of the schools, besides a series of ques- 
tions to be answered, and a theme to be written on, a patient is 
put before the candidate, who is required to investigate the case, 
to make a diagnosis, and to indicate the proper treatment. Clin- 
ical observation and experience are absolutely necessary here to 
enable the candidate to acquit himself satisfactorily. 

In consequence of the successively advancing steps of instruction 
in European schools, and the long duration of the whole course, 
it happens that the classes of any one teacher are seldom large, 



312 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

probably never so large as they often are in some of the most suc- 
cessful schools in our own country. I do not think I heard of one 
instance, in which the class exceeded three hundred in attendance 
at the same time on one professor; and this number is very rare. 
Much more frequently it is less than one hundred, even in the 
flourishing schools, where the whole number of matriculants may 
be not less than five or six hundred ; and I think I have heard of 
classes consisting of not more than one or two listeners. As the 
pupil is not bound to attend particular lectures, he makes a choice 
among several, and, of course, the most popular professors com- 
mand the largest attendance. It is not always the man of highest 
scientific reputation who has the greatest talent of teaching; and, 
not unfrequently, they with whose names the world resounds are 
compelled to address their great thoughts to empty benches. 

The number of professors is usually large, sometimes a dozen or 
more, and the subjects to be taught are consequently much sub- 
divided. This is another reason for the frequently slender attend- 
ance on the lectures. 

The lecture-rooms are generally small, and poorly furnished, 
even in the most celebrated schools. In the great school of medi- 
cine at Paris, the seats of the chief lecture-room are little more 
than an ascending series of narrow steps, arranged amphitheatri- 
cally, from the floor upwards, and I have no doubt are each day 
trodden by many feet, before they are occupied in the legitimate 
mode by their ultimate possessors ; and, in the largest room I saw 
at the University of Berlin, the seats of the audience were all placed 
upon the floor, and on the same level with that of the lecturer. 

Another remark I made in relation to the lecture-rooms was, 
that the benches frequently exhibited evidence of the use of the 
knife, showing that the whittling propensity is not exclusively 
American ; but I do not remember ever to have noticed an adorn- 
ment of the floors so common in our country, arising from the use 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 313 

of tobacco ; this luxury being enjoyed in Europe much more in the 
way of smoking than of chewing. 

I was, I confess, surprised at the moderate scale upon which the 
lecture-rooms of the European schools were planned, in reference 
both to size and arrangements. On all the continent, I did not 
meet with an apartment of the kind comparable to that in which I 
am now speaking, however moderate it may seem to you. 

In all the schools we visited, the professors receive fixed salaries 
from the government. In some, as in those of Paris and St. Peters- 
burg, these salaries constitute the whole emolument of the profes- 
sors, as such ; in others, as that of Berlin, there is an additional 
income from the students, which is proportionate to the popularity 
of the lectures. The latter appears to me the best plan of com- 
pensation. The professor is secured against absolute want by the 
fixed salary, which is, however, too small for his comfortable sup- 
port, so that he is stimulated to exertion in order to supply the 
deficiency; and this exertion is beneficial to the pupil and the 
school, as well as to himself. I met with no instance in which, as 
with us, the whole compensation of the teacher was derived from 
the students. 

There is probably nothing in which Europe appears to greater 
advantage than in the number and character of the hospitals. This 
is one of the great triumphs of Christianity, and in itself an evi- 
dence of the superiority of our holy religion over every other faith 
that now prevails, or ever has prevailed upon the earth ; I may 
say, moreover, a strong argument in favour of its divine origin; 
for it seems to have been a conception above the weakness and 
selfishness of the natural man, that society owed a debt to the poor 
and the helpless ; and that, instead of treading the feeble under 
foot, in the headlong rush of our passions and interests, we are 
bound to halt in our course, and, at the sacrifice of our own pleas- 
ures, to support the weak, to heal the sick and wounded, and "bind 
up the broken-hearted." Every large city, and very frequently, 



314 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

also, towns of little importance, are supplied with one or more 
hospitals, many of which are on a magnificent scale, and conducted 
in the most admirable manner. Those of Paris, "Vienna, and St. 
Petersburg more especially engaged our attention. If I were called 
on to decide the question of precedence between these hospitals, I 
should be inclined to say that those of Paris and Vienna accom- 
modate the greatest number of patients, while those of St. Peters- 
burg are superior in the style of the buildings, and in their interior 
arrangements. Two of the hospitals of that great city are pecu- 
liarly worthy of notice, that of St. Peter and St. Paul, and the 
General Military Hospital ; the former of which is exclusively 
civil, and the latter, as its name implies, exclusively destined for 
the army. The Military Hospital is a vast structure of brick, stuc- 
coed, and is completely fire-proof from within and without. That 
of St. Peter and St. Paul is provided, in addition to all the usual 
conveniences, with a broad hall of great length, into which the 
wards open, which is kept perfectly warm in the winter, and 
intended for a place of exercise for the convalescents, who are 
precluded from exposure to the open air, in consequence of the 
intense coldness of the weather. A peculiarity of both these hos- 
pitals is the connection with them of a slighter building or build- 
ings, admitting of a freer entrance and circulation of the external 
air, into which the patients are transferred during the hottest 
weather of summer. Throughout the interior of both, the greatest 
attention is paid to neatness, cleanliness, and the comforts of the 
inmates ; and, from what I witnessed of the ordinary condition of 
the lowest orders of the Russian population, I should suppose that 
they would deem admission into one of these establishments as a 
foretaste of Paradise. Yet I owe it to my own country to say that, 
in all Europe, though there were many institutions vastly larger, I 
saw none which, in the propriety, neatness, and I might almost say 
elegance of its interior, surpassed our own Pennsylvania Hospital. 
. Having heard what I had to tell you on the subject of medical 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 315 

education, and the medical institutions of Europe, which might 
readily have been expanded into a volume had time permitted, you 
may perhaps expect to hear something upon the character and 
condition of the profession itself. It would be quite presumptuous 
in me, with the comparatively slender-opportunities which a rapid 
journey through the continent afforded me, to attempt to give you 
any very precise or positive information on the subject. I may, 
however, be permitted to state, in a few words, the general impres- 
sions I have received. 

In the first place, it cannot be doubted that the great mass of 
the physicians and surgeons of the continent consists of men well 
educated, both professionally and otherwise. In both these re- 
spects, they are probably superior, on the whole, to the medical 
men of our own country. But I must repeat what has been already 
said, that I do not consider them better practitioners. In Europe, 
value is attached to science for itself alone, independently of any 
practical benefit to accrue from it to mankind. This is true of 
medical science as well as of general knowledge. In this country, 
on the contrary, we seek especially what is practically useful, and 
that of which the utility can be readily appreciated. We are apt 
to neglect those kinds of knowledge which cannot be brought to 
bear upon the great end of life, that of success in the business or 
profession we may have chosen, and give the time, which these 
would consume in their acquisition, to the means of fitting our- 
selves quickly for entering upon our practical career, and after- 
wards of pushing our fortunes in that career as rapidly as possible. 
This being the general feeling, and general practice, individuals 
who might be disposed otherwise, did circumstances permit, are 
compelled to give way to the current. They who amuse them- 
selves with the refinements of knowledge, and consume time in 
storing up facts of no present value, will find the paths to success 
preoccupied by the more energetic and practical. In the vast 
competition, and eager haste towards their objects, which charac- 



316 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

tcrize the people of this country, the votary of pure science, if not 
independent in his circumstances, will feel himself jostled in every 
direction, and in danger of being thrown off by the wayside, if not 
trodden under foot. The remark is not less applicable to the medi- 
cal than to any other profession or pursuit. Hence it is that the 
American physician is the more practical, the European the more 
scientific. The latter understands better the intimate nature of 
structure, and the changes produced by pathological influences, and 
is probably better acquainted with, or at any rate studies more 
profoundly the laws of our physical being as exemplified both in 
health and disease ; but, devoted as he has been to these investiga- 
tions, he gives less attention to therapeutics, is apt to be skeptical 
in everything which rests upon testimony, and turns out a compara- 
tively inefficient practitioner. The American, on the contrary, is 
apt to cast a careless eye upon the obscure depths where he can 
see no bottom, passes unheeding by the curious and beautiful re- 
sults of minute investigation, which, whatever may hereafter be the 
case, have yet, as he is disposed to think, yielded no practical 
fruits, and devotes himself to those inquiries by which he can most 
surely make the sick man well, and thereby at once satisfy his con- 
science and benevolence, and secure that good-will and favourable 
opinion upon which he hopes to build his fortunes. In making 
this contrast, I wish to be understood as by no means exclusive. 
There are a great many exceptions on both continents to the gen- 
eral rule, and not a few instances in which it is reversed. But I 
believe there really does exist a general difference, such as I have 
stated, between the medical profession of continental Europe and 
that of America; the former having a greater predilection for the 
abstractions of science, the latter for the practical realities of life, 
and both exhibiting the results of this predilection in their whole 
professional course. 

There is another circumstance which, I think, tends to make the 
American physician, other things being equal, a better practitioner 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE 3 IT 

than the European. In his eagerness for success, the former is 
seldom content with what he learns in the schools, but, throughout 
his whole active life, prosecutes his studies in a therapeutical direc- 
tion, and reads diligently everything upon which he can lay his 
hands having such a bearing; being impelled thereto not only by 
his sense of right, but by the absolute necessity of not permitting 
his neighbour to outstrip him in the race. The European, on the 
contrary, is apt to content himself with what he has learned, and 
makes little comparative effort for self-improvement, because he 
finds all things around him moving in fixed courses; so that, if 
young, he may await quietly the movement which is to advance 
him; if old and established, may rely with confidence upon the 
steady order that retains all in their due places. Whatever may 
be thought of the theory in this case, the fact is as I have stated. 
It is proved, I think, beyond reasonable doubt, by the vast differ- 
ence in the sale of medical books on the two continents. While 
in France, or Germany, a meritorious medical work may sell at the 
rate of from five hundred to one thousand copies annually; in the 
United States, though with less than two-thirds of the population 
of either of those countries, the sale of a similar work, in the same 
time, will amount to two or three thousand. 

In their social relations, I do not think that the members of our 
profession stand so high relatively on the continent as the higher 
ranks of the physicians and surgeons do in England ; and cer- 
tainly we have the advantage over them in this respect in the 
United States. In France, until a comparatively recent date, phy- 
sicians were upon a footing in general society by no means favour- 
able ; and, though the profession has, during the present century, 
been illustrated by many great men, who have much elevated their 
calling in the eyes of the community, yet practitioners of a high 
grade in Paris still eschew their distinctive title, and use upon their 
cards the same mode of designation as other men. 

Among the Germans, great scientific reputation, or the profes- 



318 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

sorial office, gives a respectable position to medical men as to all 
others; but I am inclined to think that in itself the profession is 
not specially honoured, though I confess that my means of inform- 
ation on this point were limited. 

Upon the whole, it appeared to me that the medical profession 
in Russia, confining the term to the educated class exclusively, 
were upon a better social footing than in any other country of 
continental Europe. This opinion derives much support from 
one interesting fact, which is true of no other country, not even 
our own, where we claim social equality with the highest. In 
the army, which is the most honourable body in Russia, giving 
increased dignity to the nobles, and raising its officers, even those 
of humble birth, to a level with nobility, the surgeons have the 
same rights as the other officers, rising like them through suc- 
cessive grades of rank to the highest, with corresponding emolu- 
ment. Thus, I knew in St. Petersburg a surgeon of one of the 
regiments of the guards, who, though yet a young man, had the 
rank of colonel ; and Sir James Wylie, who is medical inspector- 
general in the army, has the grade of general in the third degree, 
which, I believe, is equivalent to that of lieutenant-general in the 
British service. 

As another evidence of the position of the profession in Russia, 
I would adduce the fact, that great attention has been paid by the 
government to the subject of medical education. Not less than 
seven schools have been established by law in different parts of the 
empire, all of which are mainly, if not exclusively, supported by 
funds from the imperial treasury. Of these schools I had the op- 
portunity of seeing only that of St. Petersburg ; but, if the others 
are to be judged by that example, there is assuredly no part of 
Europe, where more munificent provision has been made for the 
education of those to whom the health of the community is in- 
trusted. The Imperial Medico-Chirurgical Academy of St. Peters- 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 319 

burg, as this establishment is officially designated, far exceeds in 
its visible arrangements any other medical school that I have seen. 
Time is not left us for a detailed account of this school ; but a few 
words will serve to give you some idea of its character, and conse- 
quently of the liberal views of its founders and supporters in regard 
to our science. An oblong plot of ground, within the limits of the 
city, having a large front on the river Neva, and extending, I pre- 
sume, more than half a mile in depth, is devoted to the purposes of 
the institution. Within these limits are several large buildings, 
two of which especially are magnificent in extent and proportion. 
In one of these, two vast wings are devoted to the accommodation 
of three hundred young men with gratuitous lodging and board- 
ing ; while the central portion is mainly occupied with one great 
hall, beautifully finished, which is appropriated to the purposes of 
a library, of public examinations, and of ceremonial observances in 
connection with the school ; and opening into it is a neat chapel 
for the religious services of the establishment. This edifice has its 
front on one of the longer sides of the oblong plot of ground before 
referred to. The second great building, scarcely less magnificent, 
presents a beautiful front on the Neva, and forms one of the most 
prominent objects in the view of this part of the city. It is occu- 
pied by the lecture-rooms, and the various illustrative cabinets or 
collections of the different professors, some of which are copious, 
and all finely displayed in consequence of the ample space allotted 
them. A separate building is appropriated to dissections; and 
there are in the grounds several low, isolated, wooden houses, which 
are employed for lodging-rooms, during the summer, of such of the 
students as do not take advantage of the vacation to scatter them- 
selves over the country. 

Besides all these appliances, there is a very large hospital, situ- 
ated on the opposite side of the grounds to the edifice first de- 
scribed, the patients in which, numbering more than a thousand, 



320 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

are at the disposal of the professors of the school for the purposes 
of clinical illustration in medicine, surgery, and obstetrics. 

In addition to the three hundred pupils supported and educated 
within the walls of the establishment, four hundred others, who 
live in various parts of the city, have gratuitous access to the 
courses of instruction, and are admitted to all the advantages and 
honours of the school. The only prerequisites to admission are 
that the applicant should be a freeman, and should prove himself, 
on examination, to have had a sufficient preliminary education. 

The examinations, I was told, are strict; and, of the seven hun- 
dred pupils in various stages of instruction, only about sixty or 
seventy graduate annually. The Emperor, who has educated them, 
considers himself entitled to their services ; and, after completing 
their course of study, they enter the army in their medical capacity. 
This, however, instead of being a hardship, is a privilege ; placing 
them at once in a respectable position, and opening a field of indefi- 
nite advancement for the future. 

After this favourable view of the medical profession in Russia, 
I should be guilty of injustice did I not call your attention to a 
great man still living, though in the extreme of old age, to whom 
much of the good that I have referred to, with a great deal more 
that I have been unable to notice, is to be ascribed. This man is 
Sir James Wylie, of St. Petersburg. All the medical men with 
whom I conversed upon the subject in Russia united in the state- 
ment, that the profession in that country owed almost everything 
to him. Withdrawn from active life, though still holding some of 
the highest official dignities, he is looked on as a man of the past, 
and spoken of almost with the impartiality of history. We were 
happy enough to form his acquaintance, and to receive various 
kindnesses at his hands. A word from him was sufficient to open 
the door to us of all that it was desirable to see in Russia; and 
our very limited time in that country would have been much less 
profitably employed had it not been for his friendly aid. Perhaps 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 321 

it is the grateful recollection of his kindness that in some degree 
prompts me to speak of him on this occasion ; but a stronger 
inducement is that I may bring before you the example of one 
who, by his own merits, has risen from an humble beginning to the 
summit of wealth and honour, and thus stimulate you, now in the 
very opening of your career, to take the steps which he took under 
the same circumstances, and without which he could never have 
risen, and no one can rise to eminence. i 

Sir James Wylie was the son of a farmer in Scotland in very 
moderate circumstances. He managed, I know not with what aid, 
to obtain a good education, and to complete a course of medical 
studies in the University of Edinburgh, the honours of which school- 
were conferred upon him when he was about twenty- one years of 
age. Immediately afterwards, in the spirit of bold adventure, he 
sailed for Russia, with nothing to depend upon but his own merits, 
and a determination to use every honourable effort to advance him- 
self in the new field he was about to enter. He had been extremely 
diligent in his studies, had employed his time to the greatest pos- 
sible advantage, and now went forth confident in himself, and pre- 
pared to seize upon and make the most of any offered opportunity. 
As one of my colleagues* said, the other day, in his elegant and 
truthful sketch of our common friend, the late Dr. Horner, f such 
opportunities come to all men, and the great point is to be pre- 
pared to take advantage of them. They will come to you, my 
friends ; and whether you shall avail yourselves of them, and, like 
the two men referred to, rise to usefulness, fortune, and eminence, 
or shall let them pass unimproved, and consequently remain in 
mediocrity all your lives, or sink into utter insignificance, will in 
great measure depend upon the course you may now adopt. Resist, 
like them, the seductions of idleness and of pleasure ; employ all 

* Dr. Samuel Jackson, Professor of the Institutes in the University, 
f Dr. Wm. E. Horner, late Professor of Anatomy in the University. 

21 



322 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

your time sedulously, with a due attention to the preservation of 
health, in the acquisition of professional knowledge; avail your- 
selves to the utmost of the advantages now offered to you; and, 
having obtained the honours of the school to which you may 
belong, persevere in the same course of self-denial, industry, and 
energetic use of opportunities ; and, depend upon it, should your 
health and lives be spared, though you may not become, like one 
of these exemplars, professor of anatomy in this school, or like the 
other the friend and counsellor of emperors, and the acknowledged 
head of the medical profession in a great country, you will, each in 
the sphere of his action, attain an equally desirable position, with 
the added consciousness that you have performed your parts well 
in the world, and the reasonable hope that a happy future may 
await you when called upon to leave it. 

Upon his arrival in St. Petersburg, Dr. Wylie found a field of 
action adapted to his attainments and powers. Having entered 
the army, he soon distinguished himself both as a physician and 
surgeon, and at the end of nine years was employed in both these 
capacities in the imperial family, being especially attached to the 
person of the Grand Duke Alexander, then a young man of about 
twenty-two, whose friendship and entire confidence he won, and 
continued to enjoy after he had become emperor, and through- 
out the life of that distinguished ruler. Thus favoured, he ad- 
vanced rapidly to the highest medical posts in the army, and was 
intrusted at various times with most important functions in refer- 
ence to the medical concerns of the empire. He was present in 
most of the great battles fought in that tremendous struggle which 
ended in the first overthrow of Napoleon ; and, after the entrance 
of the allies into Leipsic, had under his care at one time, as he 
himself assured me, 40,000 wounded, as well of the French as of 
the allies, the former having been left on the field of battle by 
Napoleon. It would be impossible, in the brief space allowed me, 
even to enumerate all the military engagements in which he par- 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 323 

ticipated from IT 93, when simply surgeon of a regiment, up to 
1828, when he attended the army in the campaign against Turkey 
in the highest medical capacity. Probably no man living has had 
under his professional care one-quarter of the number of wounded, 
whom it has been Sir James Wylie's lot to superintend. 

The confidence reposed in him by the Emperor Alexander, who 
consulted him on all occasions, enabled him to carry into effect the 
most important measures for the amelioration and improvement of 
the medical institutions, and in general of all that concerned the 
subject of health, whether in the army or the empire at large. He 
held the high posts of inspector-general of the health of the armies, 
director of the medical department of the ministry of war, presi- 
dent of the medical council of the same ministry, and president of 
the Imperial Medico-Chirurgical Academies of St. Petersburg and 
of Moscow. Through these positions he could bring his plans to 
bear upon every department of his profession ; and it is reasonable 
to suppose that the present excellent position of the medical offi- 
cers of the army, the general regulations of the medical military 
service, the very satisfactory condition and arrangement of the hos- 
pitals, and the superior character of medical education as conducted 
in the schools, have all owed much to his sound judgment, enlarged 
views, and almost unexampled opportunities. In his anxiety to 
produce regularity in the pharmacy of the army and the hospitals, 
he prepared a copious pharmacopoeia, composed in the Latin lan- 
guage, which has gone through several editions, and is, I presume, 
of legal authority in the empire. 

Sir James Wylie never relinquished his rights or allegiance as a 
British subject, and, consequently, notwithstanding his numerous 
offices and great influence in Russia, never became a subject of the 
Emperor. He could not, therefore, receive a Russian title of no- 
bility, which, under other circumstances, would undoubtedly have 
been at his command. But on the occasion of the visit of Alex- 
ander to England, George the Fourth, then Prince Regent, at the 



324 THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 

request of the Emperor, conferred on him the rank of Baronet, 
whence he derives the title by which he is generally known. Hon- 
orary presents and orders have been showered upon him, not only 
by the Russian Emperors, but by various other sovereigns; and, if 
I do not mistake, he received from Napoleon the insignia of the 
Legion of Honour, in consequence of his attentions to the wounded 
French soldiers that fell under his care. 

Sir James was never married. His fortune is immense ; and, 
as I was told in St. Petersburg, he has made his will, leaving it 
mainly to the Emperor, having, as he says, derived it from the 
favour of the imperial family.* To the members of this family he 
appears to have the attachment of a friend ; and he spoke with a 
faltering voice, and tears in his eyes, of the recent decease of the 
Grand Duke Michael, the brother of the present Emperor, with 
whom he seems to have been upon terms of affectionate intimacy. 

The greatest merit of Sir James, in my eyes, is the conscien- 
tiousness with which he directed the influence he possessed with 
the Emperor to the elevation of his profession in dignity and use- 
fulness, and to the general good of the country in which he had 
taken up his abode. On this account, much more than for his 
wealth and honours, he is held at present in the very highest esti- 
mation ; and on this basis will rest his fame with posterity, who 
will appreciate in their own advantages the good he has done, 
while they will care nothing for mere personal possessions or 
endowments, which will have perished with the owner. 

In this point, also, my friends, I could wish you to imitate the 
example that I have placed before you. Do not live solely for 
yourselves. Do not seek wealth, station, influence, merely for your 
own personal gratification ; but consider them as means for doing 

* Sir James died not a great while after our visit, and is said to have be- 
queathed his fortune, as it was presumed that he would do, mainly to the 
Emperor Nicholas. 



THE MEDICAL PROFESSION IN CONTINENTAL EUROPE. 325 

good, for spreading benefits around you, and for making an impres- 
sion on the world, which, when you are gone to your rewards, will 
cause grateful recollections to cluster about your memory, and 
your example to be held up to the young for imitation in all future 
time. Especially forget not your noble profession, and so act and 
so live as to increase its respectability and real worth, and thus 
render it an instrument of greater and greater good, not only to 
those who may enrol themselves in its ranks, but to the whole 
human family. 

If I have been able to derive, from my recent journey, any facts 
or considerations that may be useful to you now as students, or 
hereafter as practitioners of medicine, and if I have in any degree 
succeeded, according to my wishes, in placing these facts and con- 
siderations effectively before you, I shall consider the result as a 
great addition to the gratifications of the journey itself. Allow 
me to take an affectionate leave of you for the present, with the 
expression of the sincere hope that, in all our future meetings, we 
may co-operate cordially to the great end of our labours here, 
that of fitting you to become accomplished physicians, an honour 
to the school in which you will have been educated, and a source 
of unalloyed good to those among whom your lot may hereafter 
be cast. 



ADDRESSES 



TO 



THE MEDICAL GRADUATES 



UNIVERSITY OF PENNSYLVANIA. 



ADDRESSES 



TO 



THE MEDICAL GRADUATES. 



Prefatory Remarks. 

Most of my readers, I presume, are familiar with the fact that, in the 
University of Pennsylvania, which has been followed in this respect by 
most of the other medical schools, an address is delivered by one of the 
professors, at the time of the commencement, to the graduating class. 
The three following addresses had their origin in this rule. The first, 
prepared at the special request of the Medical Faculty, is occupied 
chiefly with an account of the history and character of the medical 
department of the University. In the others my aim was to impart 
lessons to the young men, which might be useful in their professional 
life. It may, perhaps, be thought by some that the expressions in 
relation to quackery, employed in these addresses, and in some of the 
preceding lectures, are unnecessarily strong; but they convey my real 
sentiments ; and it must be remembered that they were addressed to 
students, or recent graduates, with the view, not of exciting hostility 
against irregular practitioners individually, but of guarding the young 
men themselves against the possibility of falling into an empirical course, 

(329) 



330 ADDRESSES TO THE MEDICAL GRADUATES. 

!))■ placing its degradation in true and strong colours before them. I 
have always, too, endeavoured to make a distinction between the irregu 
lar practitioners who have a more or less full faith in what they profess, 
and those who act against better knowledge, with the sole view of mak- 
ing money, no matter at what cost to those whom they deceive. Any 
self-appropriation, therefore, of language referring to the latter set of 
practitioners, must be received as a confession of membership in the 
class ; and I presume that there are few honest persons, of any profes- 
sion, who would not admit the justice of the severest possible expres- 
sions of censure in such a case. 



ADDRESS I. 



DELIVERED AT THE MEDICAL COMMENCEMENT, HELD MARCH 26th, 1836. 



Sketch of the History of the Medical Department of the 
University of Pennsylvania. 

Gentlemen : — 

It is by the appointment of the Medical Faculty of the Univer- 
sity, that I now have the honour of addressing you. I should be 
proud, on any occasion, of acting as their representative; I am 
peculiarly so on the present, when the object is to welcome your 
entrance into the ranks of our profession. Allow me, on behalf 
of ray colleagues, as well as for myself, to express a cordial sym- 
pathy with you in this most important era of your lives. We 
participate in the satisfaction of your retrospective view; in the 
delight of your present relaxation from toil and anxiety; in the 
buoyant gladness of your new independence ; in the lofty aspira- 
tion, the hope, the confidence, the joy of your eager glance into 
the future. We have the whole picture of your emotions indelibly 
traced upon our memory. In our sympathy with you, we live 
over again one of the happiest and most exciting moments of our 
own existence. Our congratulations, therefore, are not the mere 
expressions of cold formality ; they are the overflowings of a real 
participation in your feelings, and of a sincere interest in your 
welfare. 

(331) 



332 HISTORY OF THE MEDICAL DEPARTMENT 

It is true that the relations which we have hitherto borne to- 
wards each other are dissolved. You have grown in knowledge 
beyond the need of our assistance, and are about to take your 
flight into the world of action, each trusting to his own strength, 
and selecting his own course, in the broad expanse before him. 
But, though we can aid you no longer, our earnest wishes for your 
true good will follow you always. One parting word of counsel, 
dictated by these wishes, will be received in the same spirit of 
kindness in which it is given. Let it enter deeply into your con- 
victions, that your success in life will depend mainly on yourselves. 
Trust nothing to fortune, or to the fancied advantages of your 
position. Labour diligently, in your intervals of leisure, to render 
yourselves more competent to the performance of your professional 
duties; guard your sentiments and conduct so as to command the 
respect of honourable men; and endeavour to cultivate such an 
exterior deportment, as may render your presence not unacceptable 
to those into whose society you may be thrown. Thus accom- 
plished, if you watch diligently the current of affairs, neither im- 
prudently rushing into the midst of adverse events, nor allowing 
any favourable opportunity for honourable action to pass unim- 
proved, you will as certainly prosper in the world, as the seed, 
sown in a good soil, and nurtured with due care, will spring up 
and ripen into harvest. The moral world is governed by laws not 
less uniform in their operation than those which regulate the 
physical. Much less is justly ascribable to accident than men are 
usually disposed to imagine. The successful often feel a pleasure 
in considering themselves the favourites of fortune ; while the un- 
successful are always willing to shift off from their own folly or 
carelessness the responsibility of their failure. But there are few 
men so purely fortunate as to be unable to point to some prudent 
forethought, or wise decision, or prompt action, as the real origin 
of their success ; and perhaps not one wretched man exists, who 
cannot recall numerous instances, in his experience, of time mis- 



OF THE UNIVERSITY OF PENNSYLVANIA. 333 

spent and opportunities neglected. With this maxim always be- 
fore you, that you must rely upon yourselves, and with the stern 
resolution to leave no honourable means untried of promoting your 
advancement, you cannot fail to attain, if not the pinnacle of your 
ambition, at least a respectable station in life, with a competent 
provision against all ordinary mischances. 

But, gentlemen, your attention will not be occupied exclusively 
with your own worldly prospects. You will not compress the 
whole current of your soul within the narrow and turbid channel 
of selfishness. By a wise ordinance of Providence, the exercise of 
an expanded benevolence is not incompatible with our true in- 
terests. If it turns away the thoughts for a moment from schemes 
of profit or ambition, it more than repays the loss by its cheering 
effect upon the heart, and its ennobling influence on the character. 
The overflow of kindly feeling, at the same time that it enriches 
the soil upon which it spreads, clarifies and sweetens the stream 
from which it proceeds, and to which it returns again. If actuated, 
therefore, by no higher motive than a regard for our own happi- 
ness, we should cultivate good-will for others, multiply friendly 
relations with objects around us, and throw out in all directions 
the cords of endearing association, by which we may reciprocally 
draw and impart refreshing sympathy and useful support. 

Among the moral associations which are least tinctured with 
selfishness, and therefore tend most to elevate and refine our 
nature, are those which continue to connect the pupil with his 
preceptors, after the immediate tie between them has been severed, 
and he has been borne by the current of time and events far away 
into some new scene of action. I cannot doubt that you feel at 
this moment, in some measure, the force of such associations. 
You will probably feel it more, when the trivial pains and anxieties 
which have intermingled with your recent labours shall have faded 
from your memory, leaving only the recollection of benefits re- 
ceived, strengthened by daily increasing experience of their value. 



334 HISTORY OF THE MEDICAL DEPARTMENT 

Often, hereafter, you will throw back your thoughts from the tur- 
moil of business into the quiet scenes of your professional study. 
The familiar countenances of your preceptors will then rise, with 
renewed freshness, before your memory. You will dwell with 
feelings approaching to those of filial affection upon their efforts 
to interest and instruct you ; at once to inspire you with a taste 
for knowledge, and to furnish the means of its gratification; to 
prepare you, in fine, so far as in them lay, for the high duties to 
which you are destined, and the noble reward to which the per- 
formance of these duties will entitle you. 

The school in which you were instructed will share in these 
feelings of affection. In the warmth of your imaginations you 
will inspire its corporate existence with the attributes of real life, 
will interweave into its character your conjoined estimate of all its 
teachers, and will love it as the centre of numerous pleasing recol- 
lections, the witness of your earnest labours and ultimate success. 
In order that you may know it more thoroughly, may appreciate 
its real deserts, and may thus be enabled to render it an enlight- 
ened support in the struggle of competition in which it is engaged, 
I propose to lay before you, on this occasion, a brief account of its 
origin, progress, and present condition. I can, perhaps, do this 
with greater propriety than my older colleagues; as, from the 
shortness of the period during which I have been officially con- 
nected with it, I cannot be supposed to appropriate to myself per- 
sonally any of the credit which may be found to belong to the 
school. 

The first conception of a plan for establishing a medical school 
in this country appears to have been formed by Dr. William Ship- 
pen and Dr. John Morgan, both native Americans, while prose- 
cuting their studies in Europe. If it be desirable to live in the 
memory of those who may come after us, the names of these gen- 
tlemen occupy a most enviable position. Placed at the source of 
a stream which must continue to flow on through ages, they will 



OF THE UNIVERSITY OF PENNSYLVANIA. 335 

be a point of search for future inquirers while civilization lasts. 
Hundreds of men of brilliant endowments, after filling the ears of 
their contemporaries with their renown, and by the impetus of 
their great minds forcing themselves far into the memory of pos- 
terity, will, in the course of time, drop one by one into oblivion 
until all are forgotten. But the future historian, though, in 
threading his way through the past, he may sweep multitudes of 
once great names as rubbish from his path, must at least preserve 
those which stand at the commencement of any great course of 
action. The fame of Shippen and Morgan will, therefore, continue 
to be cherished in this country, so long as its inhabitants shall be 
subject to physical infirmities, and the healing art be deemed 
worthy of cultivation. 

So early as the year 1762, Dr. Shippen, in the introductory to 
a private course of lectures on anatomy, announced his belief in 
the expediency and practicability of founding a medical school in 
Philadelphia. In 1765, Dr. Morgan, upon his return from Europe, 
laid before the trustees of the College of Philadelphia, which had 
then been in existence as a collegiate establishment about ten 
years, a plan for the institution of medical professorships in con- 
nection with the seminary under their direction. The plan, which 
came strongly recommended by several influential friends of the 
College in England, was adopted by the trustees, who immediately 
appointed Dr. Morgan to the chair of the theory and practice of 
physic. In the same year, Dr. Shippen was chosen professor of 
anatomy and surgery. For a short time, lectures were delivered 
by these two professors on the various branches of science, then 
deemed essential in a course of medical instruction. In 1767, a 
system of rules was adopted for the organization of the new school ; 
in 1768, Dr. Adam Kuhn was appointed professor of materia 
medica and botany, and Dr. Thomas Bond of clinical medicine ; 
and, on the 21st of June, 1768, a medical commencement was held 
for the first time in America, at which the degree of Bachelor of 



33G HISTORY OF THE MEDICAL DEPARTMENT 

Medicine was conferred upon ten individuals. The chair of chem- 
istry was added in 1769, and was filled by the appointment of Dr. 
Benjamin Rush. 

Such, gentlemen, was the germ of that school, w T hich has been 
so long scattering its fruit over every part of our vast country, and 
under whose broad shade we are now assembled, more than seventy 
years from its origin, to celebrate the return of its annual season of 
productiveness. Not less than three generations have partaken of 
its benefits ; for, in the catalogue of its first graduates, is the name 
of the grandfather of a young gentleman who now most worthily 
receives its honours, and whose father was also a graduate of the 
school.* It is beginning to be venerable in the eyes of men; for 
it is associated with the gray hairs of their fathers. But age, 
which has given it dignity, has taken nothing from its strength ; 
and it still stands erect and prominent among the numerous 
offspring which have risen up around it. Its growth at first was 
not rapid. Humble in its original organization, it gradually ex- 
panded with the increasing wants and resources of the country 
and thus acquired a solidity and permanence w T hich it would have 
failed to attain, if forced by injudicious management into a pre- 
cocious increase. 

In the year IT 6 9, when the Medical Faculty was fully formed, it 
consisted, strictly speaking, of only four professors; for the chair 
of clinical medicine appears to have been little more than nominal, 
and was abolished after the death of Dr. Bond. You will easily 
understand how imperfect must have been the courses of instruc- 
tion, when the three branches of anatomy, surgery, and obstetrics 

* Dr. Wm. Elmer, now a highly respectable practitioner of Bridgeton, 
Cumberland County, New Jersey. His father, of the same name, was also 
a graduate of the medical department; and his grandfather, Dr. Jonathan 
Elmer, at one time Senator of the United States from New Jersey, was, as 
mentioned in the text, a member of the first graduating class. 



OF THE UNIVERSITY OF PENNSYLVANIA. 337 

were taught by one professor. With this deficient organization 
the school continued till 1782, when botany was separated from 
materia medica, and erected into a distinct professorship. 

In the mean time, however, a great change had taken place in 
the government of the College. In the violence of political excite- 
ment, its charter had been abrogated by the State legislature, and 
all its rights and property transferred to a new institution, which 
was dignified with the title of University of Pennsylvania. But 
this event, which took place in the year 1779, does not appear to 
have affected the Medical Faculty, which continued, in the new 
school, to be constituted in the same manner as in the old. In 
1789, ten years after the act of abrogation, the legislature, admit- 
ting its injustice and illegality, restored to the College, by a new 
act, all its former privileges and possessions ; so that two institu 
tions now existed, distinguished by the titles of the College and 
the University. The Medical Faculty was thus, for a time, thrown 
into disorder, one portion attaching itself to the old school, and 
another to the new; and some modifications were made in the 
arrangement of the professorships, which, however, as they were 
of short duration, do not appear to merit particular notice. Hap- 
pily, the two institutions were soon afterwards reunited by a volun- 
tary agreement, which received the sanction of law; and an oppor- 
tunity was thus afforded, in the year 1791, for a new organization 
of the medical school. 

Six professorships were now recognized, under the titles respect- 
ively of 1. anatomy, surgery, and midwifery, 2. theory and practice 
of medicine, 3. institutes and clinical medicine, 4. chemistry, 5. ma- 
teria medica, and 6. botany and natural history. But this arrange- 
ment was dictated by the necessity of combining two faculties, and 
supplying places for the members of both, rather than by a sense 
of its general propriety. Hence, the chair of the institutes and 
clinical medicine was afterwards united to that of the theory and 
practice ; and the chair of botany and natural history ceased to be 

22 



338 HISTORY OF THE MEDICAL DEPARTMENT 

considered essential, when the opportunity was offered of transfer- 
ring its occupant to that of materia medica. 

In the year 1805, a great improvement was made by the estab- 
lishment of a chair of surgery, and another scarcely less important, 
in 1810, by the separation of obstetrics from anatomy, and its ele- 
vation to the dignity of a distinct professorship. From the latter 
period no material change took place in the organization of the 
school, until, by a recent regulation, the institutes were again sepa- 
rated from the practice, and placed upon an equal footing with the 
other important branches. 

From this hasty sketch you may perceive that the school has 
been gradually expanding from the time of its foundation; and 
that at no former period has it presented an organization, so nearly 
in accordance with the just demands of medical science, as at this 
very moment.* 

It would be a pleasing task to go up with you again to its origin, 
to introduce you to a more intimate acquaintance with its founders, 
and then, descending along the course of its history, to make you 
familiar with each of the great names successively that have illus- 
trated its various departments. But the attempt would be vain to 
compress so many merits within a space so short as we could now 
allot to them. Perhaps, moreover, the task would be useless. 
What name is there among the worthies who elevated and sus- 
tained this medical school, that is not in the memories and the 
mouths of all who have any pride of profession ? What medical 
man, who has at heart the honour of his country, is ignorant of 
the names of Rush, Barton, Wistar, and Physick, not to mention 
others, both dead and living, who have been associated with these 
great men in their labours and their fame? With two only of 

* I would call attention again to the date at which this address was de- 
livered; in the spring, namely, of 1836; at the end of the first course of 
lectures delivered by myself in the school. 



OP THE UNIVERSITY OF PENNSYLVANIA. 339 

those I have mentioned has it been my good fortune to have 
any personal intercourse. One of these is now beyond the reach 
of human applause or censure ; and the other stands so high in 
personal dignity, fortune, and the respect of men, and is so far 
removed from the business and agitations of ordinary life, that 
sentiments of admiration may be allowed ample scope in their 
expression, without affording ground for dishonourable imputa- 
tions. You will excuse me if I yield for a moment to the impulse 
of my feelings, and throw in my mite of tribute to their deserts. 

The name of Wistar must have called up a train of affectionate 
and touching remembrances in the minds of many who are now 
present. They can recall the affable and courteous manner, the 
heart full of kindness, the tear for distress, the cordial smile of 
sympathy or welcome, the open hand, the generous, noble spirit 
that shone in every feature, and spoke in every act. They can 
picture him in their imagination, as he formerly stood in his lec- 
ture-room, full of his subject, inspiring into all the interest which 
he felt himself, unravelling intricacies and lighting up obscurities 
by an almost magic touch, with a countenance beaming with intelli- 
gence and affection; himself the centre of a love and respect which 
amounted almost to reverence. I might speak of his general knowl- 
edge, his scientific attainments, his professional skill, the large space 
which he filled in the society and business of the city, the esteem in 
which he was held in all parts of the Union. I might dwell also on 
that sensitive delicacy of conscience which he exhibited on all occa- 
sions, whether as a teacher considering himself answerable for the 
ignorance of his pupils, as a judge deciding upon their claims to a 
recognition of their capacity to practise, or as a physician lavish of 
his time, attention, and labour, upon the sick, without reference to 
their ability to afford him pecuniary compensation, and perhaps 
without a thought upon the subject. But even an outline of the 
qualities of his heart, mind, and conduct, would extend beyond the 
limits which I could here devote to them; nor do I feel myself 



340 HISTORY OF THE MEDICAL DEPARTMENT 

adequate to their just representation. The sketch I have at- 
tempted is but a faint copy of the vivid impression, which must 
be stamped on the memory of all who knew him. It is far from 
doing justice to my own recollections of his rich and beautiful 
character. 

Not less impossible do I find it to embody in words the senti- 
ments of respect which are entertained by myself, in common, I 
am sure, with the whole of this audience, towards another illus- 
trious supporter of the school, the last survivor of those upon 
whom its fame was built, and now looked up to as the acknowl- 
edged patriarch and head of the medical profession in this coun- 
try. I need not mention the name of Physick. There is but 
one man in the Union to whom all would concede this pre-emi- 
nence. Who is there in this assembly, in this city, I might say, 
what intelligent man in the country, who is not familiar with his 
admirable skill in operative surgery, and with the numerous im- 
provements which the art owes to his genius? What medical man, 
who has had the opportunity of professional intercourse with him, 
is unacquainted with those high qualities which have placed him 
at the head of American practitioners ? his keen insight into dis- 
ease, united with the spirit of minute and patient inquiry ; his inex- 
haustible copiousness of expedient; his undaunted resolution, which 
never wavered under a sense of personal accountability; his perse- 
vering adhesiveness to an approved plan, alike against the remon- 
strances of the patient, the discouragement of medical associates, 
and the weariness of his own disappointed expectations. Hundreds 
are now living who owe life or limb to the exercise of these rare 
qualities, under circumstances which would have apparently justi- 
fied despair. Consider him as a man, without reference to his 
professional merits. What dignity of character and deportment ! 
what scrupulous regard for the just claims of others ! what perfect 
self-command ! — qualities which have placed their possessor upon 
an unassailable eminence, and have precluded the least show of 



OF THE UNIVERSITY OF PENNSYLVANIA. 341 

disrespect unless from audacity itself. But it was, perhaps, in the 
lecture-room that Dr. Physick appeared to most advantage. Those 
of us who have listened to his instructions in surgery can well re- 
member, how impressive was the dignity and earnestness of his 
manner, how clear and forcible his flow of fact and illustration. 
We can recall the absorbed attention, the profound respect ap- 
proaching almost to awe, which sat habitually upon the counte- 
nance of the class; we can recall too the delightful emotion, the 
almost electrical thrill of pleasure, which flashed through every 
breast, when his features relaxed, during the relation of some 
pleasing incident, from their usual earnest sobriety into the bright 
cheerfulness of a smile. With the title of Emeritus Professor of 
Surgery and Anatomy, Dr. Physick still lends to the school the 
influence of his great name, though prevented by feeble health 
from an active participation in its affairs. Long may the evening 
of his days continue to shed its mild radiance upon our walls! 
Long may he live to fill a place in the profession, in which he can 
have no successor! 

The school has in general been fortunate in enjoying, through a 
long series of years, the services of those among its teachers who 
were best able to advance its interests. One striking exception, 
however, is afforded in the instance of the highly gifted Dorsey,* 
whose meteor course was suddenly quenched in death at the mo- 
ment of its greatest splendour. He lived, however, long enough to 
add one flower at least to the wreath of fame which encircles the 
history of the institution, and to prove, that, had life been spared 



* Dr. John Syng Dorsey, chosen first as the adjunct of Dr. Physick in the 
Chair of Surgery, afterwards as successor to Dr. Chapman in that of Materia 
Medica, and finally, upon the decease of Dr. Wistar, in the year 1818, as 
Professor of Anatomy. He had, however, but just entered upon the duties 
of the last-mentioned office, when he was cut off by death ; so that he never 
delivered a course of anatomical lectures. 



342 niSTORY OF THE medical department 

to him, he would have earned for himself a place in the memory 
of men, scarcely less elevated than any now filled by his prede- 
cessors. 

Bewees* also had a professorial career too short for the good of 
the school, though sufficient to connect his name indissolubly with 
its history, and to entitle it to claim his ample honours as among 
its own brightest ornaments. It is no mean boast of the institution 
to have ranked among its officers the man to whom all agree in 
assigning the highest place among American obstetricians, whether 
in relation to practical skill, to merits as an author, or to diffused 
reputation both at home and abroad. Of his kind and amiable 
nature, his unaffected simplicity of character, his cultivated taste 
for the fine arts, even of his abilities as a teacher, I do not intend 
to speak. They are too well known to you all to require any com- 
ment from me. The affecting testimony of friendship and esteem 
spontaneously offered him by the class, on the eve of his departure 
for a foreign land, must be still fresh in your memory. What a 
noble scene was your last meeting with your venerable preceptor ! 
I can still see him seated in the midst of the assembled throng, in 
the very scene of his former labours, enfeebled alike by disease and 
by the crowd of emotions which pressed upon him ; come to re- 
ceive your parting token of affection, and to bid farewell alike to 
you, and to the place in which he had so often before met you in 
the full vigour of his powers. Every breast was filled with sym- 
pathy, every eye was moist with compassion ; a deep silence evinced 
the absorbing interest of the scene ; and when the last thanks and 
the last blessings, which his feeble lips were unable to pronounce, 

f Dr. Wm. P. Dewees, who was appointed, in 1825, adjunct to Dr. Thos. C. 
James in the professorship of Obstetrics, and became full professor in 1834, 
on the resignation of Dr. James. He was seized with paralysis, as he was 
about to enter upon his course, in the autumn of 1835; and, being unable 
to make himself heard by the class, resigned the professorship. 



OP THE UNIVERSITY OF PENNSYLVANIA. 343 

were read by a mutual friend, one common feeling of sadness and 
solemnity overshadowed the assembly, and one common prayer 
went up from the deepest recesses of the heart, that the remain- 
ing path of his life might be smooth, and the evening of his days 
unclouded and serene. 

In these brief sketches, I have not pretended to offer a history of 
the Medical Faculty from its first institution. In such a history, 
it would be unpardonable to pass over names, which on the present 
occasion have not been mentioned, or to give a subordinate place 
to others which have been merely alluded to. My object has been, 
in the utter impossibility of presenting a complete picture, to touch' 
off simply some points which were prominent in my own expe- 
rience or recollection, and to which, therefore, however imperfectly 
executed in other respects, I have at least been able to give the 
character of truth. 

Before the present audience, it would be superfluous to speak of 
the general prosperity of the school. It may be interesting, how- 
ever, to trace its gradually increasing success, as indicated by the 
number of those who received its honours, at different periods, from 
its foundation to the present time. 

I have already stated that the number of graduates, at the first 
public commencement in 1168, amounted to ten. This was exceeded 
only on three occasions during the remainder of the century, on one 
of which, in the year 1T97, the graduating class consisted of fifteen. 
The average annual number from the origin of the school to the year 
1800 was only seven. From this period it appears to have rapidly 
increased. In 1810, the annual list of graduates had swollen to 
sixty-five, in 1819 to one hundred and two, and in 1831, when it 
attained its maximum, to one hundred and fifty-one. Dividing the 
present century up to 1830 into periods of ten years, we find that 
the average number yearly in the first period was about thirty-three, 
in the second seventy-one, and in the third one hundred and seven; 



344 HISTORY OF THE MEDICAL DEPARTMENT 

and since 1830, it has been one hundred and thirty-two.* But the 
number of graduates is not an exact criterion of the relative pros- 
perity of the school at different periods ; for, from a combination 
of various circumstances, it has happened that the proportion of 
those who have annually received the honours of the institution to 
those who have merely attended upon its courses of instruction, has 
been gradually augmented during the latter years of its existence ; 
so that its early success was in fact greater than might be inferred 
from the statement just made. 

Originally, two degrees in medicine were conferred, correspond- 
ing with those in the arts. The prerequisites to the lower degree, 
or that of Bachelor of Medicine, were the possession of a com- 
petent knowledge of the Latin language, mathematics, and natural 
philosophy, the serving of a sufficient apprenticeship with some 
respectable practitioner of medicine, a general knowledge of phar- 
macy, and an attendance upon at least one complete course of lec- 
tures, and upon the practice of the hospital for one year. The 
higher degree, or that of Doctor of Medicine, was conferred on 
the Bachelor at the expiration of three years, upon the conditions 
that he should have attained the age of twenty-four, that he should 
write a thesis, and should publicly defend this thesis in the Col- 
lege. This system was found inconvenient in practice, and, as it 
was productive of no counterbalancing advantage, was abandoned 
for that now in operation, upon the union of the schools in IT 91. 
The regulation formerly existed, that the theses of the successful 
candidates should be published ; but this too has been very pro- 
perly abandoned, as an unnecessary impediment in the way of 
graduation. 

* From 1830 to the present date, a.d. 1859, the average number of grad- 
uates has been 154. The highest number was in the session of 1848-9, 
when it amounted to 190; the matriculating class of the preceding session, 
that of 1847-8, having numbered 509, the largest in the records of the 
school, up to the present winter, when it is exceeded. 



OF THE UNIVERSITY OF PENNSYLVANIA. 345 

We have thus, gentlemen, taken a rapid glance at the past his- 
tory of the medical school whose honours you now receive. May 
I ask your further indulgence, for a few minutes, while I attempt 
to represent to you the advantages of its present position, and the 
claims which it advances to' a continuance of the support which it 
has hitherto both merited and received ? I am sure you know me 
too well to suppose, that, in thus assuming the office of its advo- 
cate, I am actuated by any sordid views of personal profit. I 
wish you also to understand, that, in the remarks which follow, 
the Faculty of the University have not the least disposition to 
undervalue the merits of the numerous sister institutions through- 
out the country. A race is before us ; a noble prize is to be won ; 
we hail every honourable competitor with a friendly spirit. The 
very excitement of a fair and open contest is equivalent almost to 
the pleasure of victory. Let each school present its advantages 
in the strongest light, and exert its own strength to the utmost, 
leaving to its neighbour the same privilege unmolested; and, 
whichever may maintain precedence in the struggle, no just or 
honourable spirit will complain. 

Not the least among the advantages of this school are those 
connected with its locality. The city of Philadelphia, centrally 
situated in regard to latitude, far enough from the ocean for per- 
fect security, yet not so distant as to be of inconvenient access 
from abroad, sufficiently populous to insure ample opportunities 
for anatomical and clinical illustration, well supplied with libraries 
and cabinets of specimens, salubrious as a place of residence, and 
richly furnished with all the necessities and comforts of life, is 
peculiarly adapted to become the resort of medical students, and 
the focus of medical instruction for the whole Union. 

Another advantage of the University, and one peculiarly its 
own, is its relative antiquity, and the number of great names con- 
nected with it in the capacity of teachers or of pupils. The prin- 
ciple of association by which we appropriate to ourselves a portion 



346 HISTORY OF THE medical department 

of the credit or censure attached to any cause, or set of men, or 
institution with which we are connected, a principle rooted in the 
very foundations of our nature, and the source of some of the 
noblest feelings with which it is adorned, extends in its influence 
not less to the past than the present. Who does not experience a 
glow of satisfaction at the mention of the virtues or praiseworthy 
deeds of his forefathers? Who does not glory in the former 
honours of his country ? Is there one of you, gentlemen, who 
does not value his degree the higher, as proceeding from the oldest 
medical school of this continent, as connecting him with the illus- 
trious names of those who raised it into fame, as ranking him in 
that band of three thousand graduates which embraces so large 
a portion of the medical reputation of our country for the last 
seventy years? Is it not something to have frequented the same 
halls in which your fathers were initiated into the profession, to 
go out to the contest under the same flag under which they tri- 
umphed? These are not fugitive or barren associations. They 
will attend you through life ; they will intermingle in your whole 
course of medical duty; they will elevate your tone of professional 
feeling, and serve as a light and guard to your path when beset with 
doubts and temptations. Your eyes will be constantly directed to 
the bright examples of those into whose fellowship you have been 
admitted; and, while spurred on by an honourable emulation to 
imitate their course, you will feel an additional obligation to avoid 
any disgraceful act, lest it may in some measure sully their fair 
fame. There is, therefore, something more than the mere gratifi- 
cation of feeling ; there is positive benefit in a connection with the 
age and reputation of the University ; and few, I will venture to say, 
have ever repented the choice which led them to this connection. 

But do not imagine that I recur to the past from any conscious- 
ness of present weakness. The University has not yet arrived at 
the period, when it will be compelled to resort to its hoarded 
capital of reputation. If success be accepted as a criterion of 



OF THE UNIVERSITY OE PENNSYLVANIA. 347 

merit, it can still boast, amidst the powerful efforts of numerous 
rivals, a degree of support, not inferior, upon the average of a few 
years, to that which it enjoyed when it stood comparatively alone. 
It cannot be denied, that the new institutions which have struck 
their roots deeply into the soil once exclusively its own, have 
drawn off much nutriment that would otherwise have contributed 
to its further expansion ; but, though thus checked in its growth 
it has lost none of its ample proportions, and still throws out its 
undiminished limbs, the pride and boast of this continent. If it be 
judged by the character of its fruit, it has still less of which to be 
ashamed. Search for the rising professional merit of this country, 
the budding of future professional reputation ; where will you find 
it if not among the pupils of this school ? When did classes ever 
proceed from its walls, more rife with the seeds of honour and use- 
fulness to their country than those of the last few years ? 

Consider now the organization of the school. Has it not been 
advancing with the general march of improvement, and is it not at 
this moment more perfect than at any former period ? You are 
all aware of the addition of a new and most important professor- 
ship, that of the institutes, made before the commencement of the 
late session. What school in the Union can boast at present of so 
extensive a course of instruction ? Little more is wanting to ren- 
der its organization entirely equal to the present advanced state 
of medical science, so far, at least, as accords with the institutions 
and habits of our country. But it has been deemed safest to pro- 
ceed cautiously with changes ; to allow the new work to become 
consolidated by time, before venturing upon further additions. In 
the mean while, the attention of the Faculty has been directed to- 
wards the improvement of the several courses which enter into its 
present plan ; and as one of the means of such improvement, they 
have now under consideration the propriety of extending the 
winter session to five months, thereby relieving the pupil, and at 
the same time affording scope for more ample instruction. 



348 HISTORY OF THE MEDICAL DEPARTMENT 

The resources in possession of the school for the illustration of 
the various demonstrative lectures, have accumulated beyond all 
example in this country. The chemical apparatus i3 probably in- 
ferior in variety, splendour, and costliness to none in the world. 
The anatomical museum, commenced by Dr. Wistar, has been 
augmented by the indefatigable industry of the present professor 
to an extent which leaves little to be desired. You can all 
bear witness to its richness in every variety of specimen, draw- 
ing, and model which can serve to illustrate the obscurities of 
anatomical structure; and it would be impossible anywhere out 
of Europe to find an equal collection of pathological specimens. 
Surgery also is illustrated in every mode of which the subject is 
susceptible ; and the magnified drawings connected with this 
branch, independently of their merit as pictorial representations, 
are worthy of notice as specimens of art. The same spirit of im- 
provement has been carried into the obstetrical chair; and you 
have been presented, during the last winter, with illustrations in 
this department such as have never before been witnessed in our 
school. It does not become me to speak upon the subject of 
materia medica. I may, however, be permitted to say, that my 
object has been to place this among the demonstrative branches ; 
and that, if I have failed to render the subject interesting and im- 
pressive, it has been from deficient ability, not from the want of 
assiduity in providing the requisite means. 

It is unnecessary to call your attention to the ample accommo- 
dations of the present hall for every department of medical instruc- 
tion. Among its recommendations, not the least is the opportunity 
afforded by its open precincts for free ventilation, and the conse- 
quent prevention of that injurious influence upon the health which 
always results from the confined air of close and crowded apart- 
ments. 

The system of clinical instruction, which, in its present form, 
owes its origin to the professors of this school, has been carried to 



OF THE UNIVERSITY OF PENNSYLVANIA. 349 

a perfection before unknown in the United States. By the ample 
arrangements of the two hospitals, particularly of that attached to 
the Philadelphia Almshouse, it has been found possible to afford 
the advantages of practical illustration in medicine and surgery to 
the largest classes ; and you must all be sensible, from your experi- 
ence during the past winter, of the benefits which flow from this 
mode of instruction. 

To complete a view of the present condition of the school, it 
would be requisite to portray the qualifications of the several pro- 
fessors ; but upon this subject I am not permitted to speak. Were 
I to express all that I think in relation to my colleagues, I should 
incur the suspicion of being influenced by the partiality of interest 
or of friendship. This much, however, may be said, that one com- 
mon feeling animates all the Faculty; a disposition to promote, so 
far as lies in their power, the usefulness of the school, and a deter- 
mination to exert, to the utmost, whatever abilities they possess, to 
render their courses instructive and interesting to the pupil, and 
honourable to the institution. 

I have addressed you on the subject of the school, without re- 
serve. By the possession of its honours, you have become, in some 
measure, partners in its fame. Sympathizing with those who have 
its prosperity at heart, and disposed to participate cordially in the 
furtherance of their honourable views, you have a right to all the 
information which it is in our power to communicate. The Faculty 
rely on your good-will. They leave their cause confidently in your 
hands; and I am much mistaken in the nature of those feelings 
which serve as the bond between you and them, if they will ever 
have occasion to repent the trust. 

You are now about to leave us, in order to enter upon the 
active business of life. I see a varied scene before you ; but hope 
at present sheds her bright sunshine over all. I would not damp 
by one word the ardour of your young wishes, or the warm energy 
of your resolves. I would not repress, if I could, that eagle gaze 



350 HISTORY OF THE MEDICAL DEPARTMENT 

into the future, which pierces through cloud and storm, to fix upon 
the bright sun beyond. The loftier your aim, the more vigorous 
and sustained will be your flight, and the higher your ascent into 
the fortunes and honours of this world. But there is one point of 
the utmost importance to your happiness, wherever your course 
may lie, whether high or low, in light or obscurity, among abund- 
ance or want; a strict observance of the rules of honour and 
morality. Without this, your greatest success will be nothing 
more than a splendid failure. A secret consciousness will poison 
every pleasure, mingle a sense of disgrace in every triumph, and 
darken the whole soul, even amidst the sunniest fortunes. With 
it, on the contrary, scarcely any condition can be absolutely des- 
perate. The storms of adversity will never find you without a 
cloak to protect, nor the fiercest assaults of grief without a solace 
to comfort you. But, while such are the advantages of an upright 
life in the lowest extreme of fortune, it very seldom happens that 
they who adhere to it have occasion to invoke its consolations 
under such unhappy circumstances. The scriptural declaration, 
"never have I seen the righteous forsaken," is but the expression 
of a general law of nature. The exercise of a conscientious guard 
over our propensities to evil, will be found an almost certain road 
to respect and confidence; and, united to a spirit of enterprise and 
the habit of industry, will prove a powerful instrument of elevation 
to the highest stations attainable in well-regulated communities. 
In your pursuit, therefore, of fame and fortune, never lose sight of 
this polar star. Turn not to the right or the left at the bright but 
delusive promise of the meteor lights which will entice you. In 
the path of your ambition, if duty or honour place but a straw in 
your way, pass not regardless by, but remove it before venturing to 
proceed. 

We feel a deep interest in your honour and success ; we point to 
the path in which you may almost surely prosper ; and if, in this 
parting moment, our wishes and admonitions assume a character 



OF THE UNIVERSITY OF PENNSYLVANIA. 351 

of solemnity, it is in accordance with the occasion ; the last of our 
meeting together, after a long and satisfactory intercourse. Yes, 
gentlemen, it is a solemn occasion. In thus parting forever, we 
stand, as it were, upon the brink of eternity; and our thoughts 
irresistibly rise up to that power which rules the vast obscure into 
which we are about to enter. If, weak and faulty as we are, we 
may venture to approach the pure majesty of His presence, we 
would earnestly ask for those who are about to embark upon the 
untried ocean of active life, a long course of virtuous prosperity ; 
a career full of happiness to themselves, and of blessings to their 
fellow-men. Gentlemen, farewell 



ADDRESS II. 



DELIVERED TO THE GRADUATING CLASS AT THE COMMENCEMENT 
HELD APRIL 2nd, 1841. 



Gentlemen : — 

In compliance with custom, and with the dictates of their own 
feelings, your teachers propose to address to you a few words of 
congratulation, of counsel, and of good wishes, before they and you 
part, never to meet again in the same relation. We have endeav- 
oured, to the best of our ability, to aid you in preparing for the 
duties upon which you are about to enter ; we have carefully and 
solicitously examined your qualifications for these duties ; and we 
have had pride in presenting you to the authorities of this school 
as meriting its formal testimonial iu your favour. That testimonial 
you have received in the degree of Doctor of Medicine which has 
just been conferred upon you. We congratulate you upon your 
honourable entrance into the ranks of our profession, and gladly 
offer you the hand of fellowship. But we shall not have fully dis- 
charged our obligation, without adding to the lessons you have 
already received some hints, out of the stores of our experience, 
which may be found useful in the long and arduous course of life 
you this day commence. 

You have gained one great requisite to success; a good start- 
ing-point from which to throw yourselves forward into the future. 
With the aid of your teachers, you have risen above the obstruc- 
tions which impede every attempted flight from the surface, and 
(352) 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 353 

have reached a spot in the ascent of knowledge, whence enterprise 
may boldly spread her wings in the air, and be assured of support. 
But it would be a great mistake to content yourselves with this 
advantage. No error is more fatal to the young physician, than 
the notion that the period of study is passed, and that hereafter he 
has only to act. To sustain a vigorous advance, it is necessary 
that, to the store of intellectual strength which he has accumulated 
in youth, he should make incessant additions at every stage of his 
progress. His ascent, unlike that of the projectile whose velocity 
diminishes constantly as the original impulse upon which it de- 
pends is exhausted, should rather resemble the flight of the eagle, 
who draws in new strength with every inspiration, and mounts 
steadily towards his goal. The knowledge which you have ac- 
quired should be considered only as a key to the vast storehouse 
whose riches are now open to you. If you aspire after excellence 
in your profession, merited success in life, and an honourable dis- 
tinction ; and there is probably not one among you who does not 
cherish such aspirations ; you will look upon the present merely as 
a period of holiday relaxation, to be followed by renewed labour in 
the attainment of medical knowledge. 

It is not probable that your time will for some years be quite 
absorbed in practical duties. The course of things, in this world, 
is much better ordered than if left to our own wishes, wilich, in the 
eagerness of pursuit, would leap over all obstacles, and if possible 
annihilate time and space. Existence, under our own guidance, 
would be nothing more than a rapid succession of wish and frui- 
tion ; a thunder-storm in the night, with its flashes and its peals, 
and darkness between. We should lose the gentle excitement of 
alternate hope and fear, the pleasingly changeful sunshine and 
shadow of the landscape of life. We should lose the sweet reward 
of mental and bodily toil ; the sense of enjoyment, namely, which 
Providence kindly mingled with the cup of labour which he gave 
to all men to drink. We should lose, moreover, those luxurious 

23 



354 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

intervals of repose, when, seated beneath our own arbour, at our 
own household door, with all that is most dear about us, we look 
out upon the green, the blossoms, and the fruits, and feel that they 
are all ours, and that we have earned them. Be assured, gentle- 
men, that rapid and unearned success in life is not desirable. It is 
well, therefore, in reference merely to your own good, not to speak 
of the good of others, that you should have further time for prepa- 
ration ; that the practical business of your profession should come 
gradually, so that while your circle of duties is widening, you may 
have the opportunity of extending equally that of your qualifica- 
tions. 

You may ask for instruction as to the course of study best calcu- 
lated to advance you in the knowledge of your profession. In the 
first place, it is highly important that you should proceed with sys- 
tem. Desultory medical reading may furnish you with a mass of 
rich materials ; but they will be irregularly heaped together in 
your memory, and mingled, moreover, with much that is merely 
rubbish; so that, in answering the demands of practical emer- 
gencies, you may ransack your store in vain for the desired object, 
and, in your haste and confusion, will even be liable to draw forth 
for use something wholly inapplicable to the end proposed. There 
is, moreover, in this sort of reading a dissipation which, as in every 
other pursuit, whether mental or physical, enervates the faculties 
which are called into play, and, if long indulged, unfits for any 
steady and laborious effort. In your medical studies, therefore, we 
would advise you to fix upon some systematic course, beginning 
with those elementary subjects which lie at the basis of the science, 
and, in your progress upwards, endeavouring always to master first 
those points in the ascent, the possession of which will facilitate 
your attainment of something higher. 

But our science includes several distinct practical departments, 
in all of which it is scarcely possible for any one individual to 
attain great proficiency. We may err almost as much by perse- 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 355 

veringly endeavouring to carry more than our arms will hold, as 
by being content with less. The greedy little child, who, unwilling 
to relinquish any portion of the desirable things within his reach, 
finds one thing after another falling from his arms as fast as he fills 
them, and at last, after repeated efforts, lets them all drop and 
begins to cry, is but the miniature of the ambitious student who 
wishes to learn everything, and, failing in the attempt, gives up in 
despair, and abandons study altogether. The best course is that 
each one should consult his peculiar turn of mind, and, as far as 
possible, his capacity, and give a corresponding direction to his 
studies. In medicine, a certain degree of acquaintance with all 
the branches is desirable, and to one whose sphere of action may 
lie in the country, is indispensable ; but special skill is attainable 
only by a concentration of effort; and he who wishes to excel 
should push his investigations preferably along some one route, 
though he may profitably cast his eye over the neighbouring tracts 
as he proceeds, and may occasionally diverge so as to get a general 
view of the whole region. 

The steady pursuance, however, of a certain course of study 
should not prevent you from paying a particular attention to those 
forms of disease which may happen to come under your notice. 
We always read more intelligently, aad better remember what we 
read, when the object of study is before us. Whenever, therefore, 
a case may occur to you, upon which you may be conscious of insuf- 
ficient information, suspend for a time your regular plan, until you 
have investigated, in relation to the complaint, all the authorities 
within your reach. Such interruptions, though they may break the 
continuity of the stratum of your studies, will, like cross-veins of 
some precious metal, greatly enhance their value. In exploring 
your memory for resources in any case of difficulty, you will find 
these deposits at once most obvious to your researches, and most 
productive of the aid you seek for. 

I cannot leave this subject, without again endeavouring to im- 



356 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

press upon you the importance of devoting the early years of your 
practical life to the continued prosecution of your medical studies. 
The physician who considers his degree as a dispensation from 
future intellectual labour, and henceforward looks only to the fruits 
of his profession, will be apt to reap but a scanty harvest; or, even 
should fortune cast his lot on some rich prairie soil, which yields 
abundantly to a very careless culture, he will find himself unpre- 
pared to gather in the abundant crop, which may thus perish upon 
his hands. It will be in vain, when he begins to experience the want 
of more ample professional resources; when he finds the magic 
stream which he has set in motion by an accidentally discovered 
word, flowing in upon him, and threatening to overwhelm him, 
because unprovided with that other word which would enable him 
to control its movements ; it will be in vain, at this late period, 
that he may strive to repair the consequences of early neglect, and 
seek safety for his reputation, and peace for his conscience, by a 
late pilgrimage to the shrine of science. Knowledge, like the 
fabled Roman sibyl, makes the offer of her treasures once, twice, 
thrice, on each successive occasion diminishing the amount offered, 
and at length threatening to withhold all if her last offer is rejected. 
As we advance in life, we find it impossible to break through the 
crust, which early neglect may have allowed to gather around our 
faculties, and which has become hardened by habit. It is only by 
a constant expansion that, like the young growing shellfish, the 
intellect can prevent that concretion which is ever disposed to form 
about it, from becoming so firm as to restrain all future increase. 
A neglect of your early opportunities will prove in great measure 
irreparable, when time and experience shall bring with them a due 
sense of their importance. On the contrary, by cultivating assidu- 
ously those opportunities, you will find your knowledge growing 
with the growing demands upon it; you will experience a happy 
harmony between your avocations and your capacity ; and, when 
in the full career of business, with the life and temporal happiness 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 357 

of great numbers in your keeping, though you may feel sensibly 
the deficiencies even of the highest knowledge, you will at least 
escape the ever-present and ever-gnawing consciousness, that your 
capabilities are not only beneath the level of your times, but also 
far beneath what nature and opportunity would have enabled them 
to become. 

The point, perhaps, next in importance to the acquisition of a 
due store of medical knowledge and skill, is the cultivation of a 
proper professional spirit. This is to the physician the very soul 
of his occupation, which, without it, would be a mere lifeless in- 
strument for the supply of his necessities, a dead compost to 
quicken and nourish the crop of his sordid enjoyments. He who 
considers his profession as an avenue to nothing higher than pecu- 
niary gains, and limits his efforts accordingly, will find his capacity, 
and, unless under strong religious influences, his conscience -also 
dwindling to the measure of his views. Next to an ever-present 
feeling of responsibility to a higher power, there is no principle so 
influential in promoting every liberal and useful effort, in restrain- 
ing every irregular or sordid act, in giving a high tone at once to 
sentiment and conduct, as a true professional spirit, which looks 
beyond personal profit to the respectability, honour, dignity, and 
general usefulness of a calling. 

But this principle should not be confounded with the esprit de 
corps, which is nothing more than a sort of cohesive affinity be- 
tween the constituent particles of an aggregate body, a selfish 
principle which yields for the sake of receiving support, which has 
no reference to the aims of the mass which it actuates, and is quite 
as efficient for evil as for good. The true professional spirit for- 
gets the individual in the great objects of the profession; the 
esprit de corps thinks of the calling only from its connection with 
the individual. The former can exist only where there is some- 
thing great, or noble, or useful to support it, and breathes most 
freely in a pure atmosphere ; the latter lives as well on garbage as 



358 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

on luxuries, and finds a congenial air wherever there is a crowd. 
The esprit de corps requires no cultivation. It springs up spon- 
taneously in the soil of association, and flourishes vigorously upon 
the passions, the interests, and the selfish calculations which are 
everywhere abundant. The true professional spirit, on the con- 
trary, is a delicate plant, which is developed only under the warmth 
of generous feeling, requires the careful nurture of good principles 
and dispositions, and is in constant danger of being choked by the 
sordid growth around it. But then it is exceedingly sweet and 
beautiful ; and its fruit is honour to the profession and benefit to 
mankind. * 

This feeling naturally arises, in a well-constituted mind, upon 
the perception of an elevated character, and of noble and benefi- 
cent objects in the profession to which it is attached. Let us ex- 
amine how far the profession of medicine offers such claims to the 
devotion of those who have enlisted themselves under its banner. 
You will surrender yourselves with a more complete and more 
hearty self-abandonment to the service of your new mistress, 
should she be found worthy at once of your highest esteem and 
your warmest affection. 

In estimating the character of a profession, we should consider 
the nature of the qualifications required for its due exercise, the 
end towards which it is directed, and the influence it is calculated 
to exert upon its votaries. Deficiency in any one of these re- 
spects would be a serious drawback to its merits ; while excellence 
in all would give it a claim to the very highest consideration. A 
few words on each point will serve to indicate the proper position 
of our profession. 

I know of no calling which requires a wider extent of knowledge 
for its due exercise. The study of medicine considers man both 
physically and morally, both in a healthy and diseased state, and 
in all those relations which have any bearing upon the soundness 
of his body or mind. It goes out into exterior nature, and 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 359 

investigates intimately every agent which has the power to pro- 
duce, to prevent, to cure, or to alleviate disease. It inquires into 
the mutual action and reaction of bodies, and into the changes 
in nature, form, or position resulting therefrom, so far at least 
as these circumstances are connected with the functions of the 
human system, the operation of exterior agencies upon that sys- 
tem, or the modification of such agencies by natural or artificial 
causes. Anatomy,, physiology, pathology, psychology, botany, 
mineralogy, zoology, chemistry, and natural philosophy, are but 
a portion of the sciences which contribute to the constitution, or 
themselves form a part of the complex science of medicine. The 
accomplished physician is also expected to have some acquaint- 
ance with the languages of Greece and Rome ; and, if he wish to 
avail himself of all the resources within his reach, must cultivate 
also those modern languages, such as the French and German, 
which are the most frequent vehicles of new medical thoughts, 
facts, and disquisitions. As a gentleman, moreover, associating 
intimately with the best instructed and most polished members of 
the community, he should be more or less conversant with polite 
learning, and familiar with the various topics of the day, whether 
literary, scientific, or political. 

But knowledge is not his only essential qualification. He 
should possess, in addition, a practical skill derived from a close 
personal observation of disease, and of the application and effects 
of remedies. He should have the graces of a gentlemanly deport- 
ment, and familiarity with the conventional forms of good breed- 
ing; so that he may avoid wounding the often morbid delicacy 
of his patients, and adding the irritations of an offended taste, 
or ruffled temper, to the evils of the disease. He should be 
endowed, in an eminent degree, with the qualities of a good 
heart, rectitude of principle, and firmness of purpose; for in 
no profession are the temptations to a relaxation in the per- 
formance of duty stronger; and in none are the consequences of 



3G0 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

such relaxation so fatal to comfort and happiness in this world. 
I need scarcely say, in fine, that a good, native intellectual basis, 
is essentially requisite for the erection of that superstructure of 
knowledge which is expected of every physician ; and that the 
faculties of a quick perception, good judgment, and accurate 
reason, are indispensable to a just solution of the intricate pro- 
blems, which disease frequently presents both in its nature and 
mode of cure. It is a great mistake to select medicine as a sort 
of hiding-place for deficient intellect; for, though a solemn ex- 
terior may for a time impose upon the public, it cannot long con- 
ceal the vacancy within from penetrating eyes ; and the mischief 
which may have accrued, in the mean time, is incalculable and irre- 
mediable. 

Such, then, are the qualifications in knowledge and character 
which the accomplished physician brings into the practice of his 
profession. Let us inquire whether the objects for which he em- 
ploys them are of equivalent importance. These objects are the 
preservation of life, and the restoration and maintenance of health. 
None, certainly, can be of higher value in reference to this world 
alone. But the mere mention of them produces little impression. 
When life first opened upon us, there seemed about it a holiness, 
like that of the ark, which it was sacrilege to touch. We shrank 
with a shuddering fearfulness from the thought of its extinction; 
and the word which spoke of our mortality, thrilled through us like 
a summons to judgment. Language was then a true picture of 
reality. But we have subsequently heard so much of life, death, 
and futurity, that our sensibility to the awful import of these 
sounds has become exhausted. Like the oft-repeated tolling of 
the church bell in our vicinity, they fall upon our ears, but we do 
not hear them. We are told of the value of life, and readily admit 
the fact; but it makes no impression, and we turn away to some 
indifferent object. We acknowledge the great importance of the 
profession whose business it is to save life ; but we do not feel it. 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 361 

To realize its importance we must be, or imagine ourselves, in a 
situation to require its aid. Let this touchstone be applied to the 
profession of medicine. 

Suppose yourselves upon a sick bed, in the crisis of a very dan- 
gerous disease, with the full consciousness of your condition. You 
look through the portals of eternity, and view an awful obscurity 
before you. The past, with its joys and its troubles which now seem 
joys, its hopes and fears, its host of things done and undone, its 
certain faults and doubtful virtues, whirls through your recollec- 
tion like a long dream of enchantment, from which you are about 
to awake into some dread reality. The sweet affections of this 
world entwine about your retreating form, and strive to hold you. 
Connubial and kindred love cling with fond arms around you, and 
with tears entreat you not to desert them. But an irresistible 
force seems to impel you onward. You are on the brink of the 
abyss ; a dizzy mist comes over your senses ; you are on the point 
of falling. But the eye of professional skill is watching over you, 
and, at the moment of despair, an arm is extended to save you. 
With its support and guidance you return to life and health ; and, 
oh! what joys attend your path. How beautiful is every object; 
how balmy the air ; how delicious the fragrance ; how sweet the 
music around you ! Nature springs with radiant smiles and ex- 
tended arms to meet you. Every sense appears to have been bap- 
tized into a new and exquisite susceptibility of enjoyment. Life 
and its affairs have acquired new interest to your regenerated 
feelings. Your bosom swells with kindly emotion towards every 
animated thing; and your thoughts ascend, from the midst of the 
temple of your enjoyment, with deep humility and ardent thankful- 
ness, to the author of all. This is no fictitious picture. Thou- 
sands and tens of thousands are realizing it every day. 

But it is not our own lives only, with all their renewed enjoy- 
ments, that we sometimes owe, under Providence, to the skill of 
the physician. We are often in want of the same aid for those 



362 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

most dear to us. There are many present, I have no doubt, who 
have sat by the bedside of some near relative in alarming illness, 
watching with anxious eye each movement of the patient, fearful 
that every breath might be the last, and longing, with a scarcely 
repressible impatience, for the approach of him upon whom every 
earthly hope depended. And when at last the physician came, 
with what trembling eagerness was he greeted ! How intensely 
did the strained eye scan his features, to gather from their ex- 
pression the message of hope or despair! What relief, what joy, 
when the inquiring gaze was answered by a smile of encourage- 
ment and confidence ! How did the heart overflow with gratitude 
for that kind watchfulness, that unwearied attention, that skill, 
which had brought the tempest-tossed bark, laden with so many 
hopes, once more to a safe haven ! It is in such moments as these 
that we feel the full value of medical services. 

Even when the efforts of the physician are unsuccessful, there 
is a priceless consolation to the survivors in the reflection, that 
nothing has been left undone which skill could accomplish. The 
practitioner, indeed, often finds, with some surprise, that his warm- 
est and firmest friends are those who have lost some dear relative 
under his care. His kind attentions are indissolubly associated 
with the memory of the dead; and no petty feeling of self-love, 
which too often endeavours to lighten a burdensome sense of obli- 
gation by undervaluing the favours received, can, in this instance, 
mar the first impression of affectionate gratitude. 

Were our profession unable to prolong life, were its only service 
to shorten and alleviate disease, and render life more comfortable, 
it would still be the instrument of great benefit to mankind. How 
often do we see pains almost beyond human endurance, which ex- 
tort groans and even cries from the strong man, retiring at the 
command of the physician, and leaving the patient, to use a fre- 
quent expression of his own, in a heaven of relief! How often 
are the discomfort and unfitness for any useful exertion, which have 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 363 

been running through months of some chronic malady, cut short in 
a few days, or in a few weeks, by medical interference ! Not to 
speak of the immense mass which is thus, in the aggregate, taken 
off from the load of human wretchedness, the contribution which 
is made to the productiveness of human industry, in all its forms, 
by augmenting the time and capacity for labour, is altogether in- 
calculable. Not only, therefore, does our profession accomplish 
its own immediate ends of preserving life and health, with all their 
abundant blessings, but it indirectly also promotes the ends of 
every other profession, by augmenting the agency through which 
these ends are attained. 

It yet remains to inquire what are the influences of our profes- 
sion upon its own members. At the very threshold of this inquiry 
we are met by two notions, to a certain degree prevalent, that the 
study of medicine disposes to infidelity, and its practice to disputa- 
tion and strife. That there have been many unbelievers among 
physicians, and that public attention has been occasionally called 
to our disputes, is not denied. But of what profession or pursuit 
in life cannot the same be said ? The chief cause of our peculiar 
reputation in these respects, is probably the circumstance that we 
are distinguished by a peculiar designation, which reflects more or 
less upon the whole class the credit or discredit of each individual. 
If a lawyer, a soldier, a merchant, or a gentleman without profes- 
sion, should happen to be an unbeliever, or should be so unfortu- 
nate as to quarrel with his neighbour, the imputation rests with 
.himself, and no one thinks of inquiring to which of these several 
classes of men he belongs, much less of fixing his fault or his mis- 
fortune upon his calling. But if a physician fall into the same 
predicament, his title of doctor directs the public attention at once 
to the great body of doctors, and we are compelled to pay for the 
very doubtful honour of our distinctive designation, the very extra- 
vagant price of public odium. Nay, the faults and follies of those 
who bear the same title as ourselves, without belonging to us, go 



304 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

to swell the charges against our profession ; and I doubt not that, 
by many, the crimes of the late notorious Dr. Francia himself are 
In id at our door. The truth is that, among physicians as among 
other men, there are believers and unbelievers; and that, as other 
men, we occasionally differ among ourselves, and are so unwise as 
to bring our differences before the public ; but that there is any 
peculiar tendency in the profession to either of these results, is 
altogether a mistake. On the contrary, the natural tendency of 
medical studies, by bringing before the mind innumerable instances 
of the wisest and most benevolent design, is to impress strongly 
upon the conviction the existence and attributes of Deity ; and, at 
least within the circle of my own observation, a remarkable har- 
mony prevails in the profession, even in iustances where there is 
an apparent opposition of interests. 

It scarcely consists with the occasion to enter into a philosophi- 
cal disquisition upon the influences of profession in the formation 
of character; otherwise it would not be difficult to prove, that 
each practical pursuit has a tendency to stamp its own peculiari- 
ties, in a greater or less degree, upon the individual; so that, if 
the course of study be comprehensive and liberal, and the course 
of action nobly directed, the intellectual and moral character will 
be in a corresponding degree expanded and elevated. Now it has 
been shown that the study of medicine covers a vast tract of human 
knowledge ; and it may be said to join, by an indefinite boundary, 
many of those departments which do not absolutely fall within its 
limits. It has been shown, also, that its practice is directed to the 
noblest results of human pursuit, short only of those which are to 
be found in a future existence. If, then, there be truth in human 
reason, the general character of the profession, wherever circum- 
stances admit of its legitimate and full development, should be at 
once liberal and exalted, embracing a wide expanse of diversified 
interest, and elevated above mean and sordid views and calcula- 
tions. And are not the deductions of reason justified by observa- 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 365 

tion ? In those countries where medicine has been duly cultivated, 
do we not find physicians prominent among the competitors for 
honour in almost every branch of literature and science ? Are not 
their names enrolled, in large proportion, in the catalogue of every 
learned society ? Is there a feasible project of public usefulness 
which does not receive their support? Is there a charity to which 
they do not contribute largely out of their comparatively slender 
means, and still more largely by their services, professionally and 
otherwise ? Most assuredly there is no profession which gives up 
more of its time, and labours more assiduously, without reference 
to pecuniary compensation, than the medical. Endowed by its 
very constitution with peculiar faculties for the relief of human 
misery, it is impelled to the exercise of these faculties whenever 
occasion offers, and is thrown, almost by the necessity of the case, 
into a course of benevolent action. I presume that I am rather 
falling short of the truth than exceeding it, when I state my im- 
pression, that at least one-half of the time and service devoted by 
physicians to practical professional pursuits, at all events in large 
cities, is entirely gratuitous. It is indeed a question whether this 
disregard of their pecuniary interests is not carried by physicians 
to the very verge of injustice ; whether they have not so long accus- 
tomed the public to expect gratuitous service, that it has at length 
come to be considered as a right ; whether, in fine, the readiness, I 
had almost said eagerness, with which they seize upon every oppor- 
tunity for the charitable exercise of their skill, has not produced a 
general impression that, on all such occasions, they, and not the 
public, are the favoured party. 

Nor is it only in the prompt surrender of their time and efforts 
at each call of duty, irrespective of all direct emolument, that phy- 
sicians illustrate the generous and liberal spirit of their profession. 
In the ordinary avocations of life, a useful invention or discovery 
is considered as a just title to peculiar emolument; and no one 
hesitates to avail himself of the law which secures to him, for a 



3f>G AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

limited period, the exclusive control of the new source of profit 
which lie has created. But it is not so with physicians. The re- 
sults of their labour and genius, whether new views of disease, new 
remedies, or new processes of cure, though years, nay a lifetime of 
labour and research may have been devoted to their discovery and 
elaboration, are unhesitatingly thrown into the lap of the profes- 
sion, and made the common property of all. It is considered alto- 
gether unprofessional to keep secret, with a view to pecuniary 
advantage, any valuable remedy; and few regular physicians or 
surgeons have deigned to resort to the protection of the patent 
law. The only legitimate advantages to the individual, according 
to the strictest professional code, are the credit of the discovery, 
the consequent probable increase of profitable occupation, and the 
heartfelt satisfaction attendant upon the consciousness of having 
contributed to the honour of the profession, and to the general 
good. 

Such, gentlemen, in its character and tendencies, is the profes- 
sion to which you now belong. It is a profession of which you 
may well be proud ; affording scope for the exercise of your best 
faculties and affections; tending by its noble purposes to elevate 
you above all that is low and sordid ; and making you the hon- 
oured instruments of the greatest earthly good to your fellow-men. 
Open your hearts, gentlemen, to the spirit which it would breathe 
into you, and cherish this spirit, like a sacred fire, by the vestal 
ministration of your highest and purest feelings. Commingled 
with your moral sense, it will shed a bright light about your steps, 
which in the darkest period of temptation will enable you to keep 
in the true path of honour and usefulness. Before this light, the 
phosphorescent splendour which often beautifies corruption itself 
will fade away, and you will see the rottenness as it really is. The 
glittering exterior of dishonourable success, which so often reflects 
the images of proud triumph to the eyes of the multitude, will be 
found a mere tinsel cover to self-reproach and conscious degrada- 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 367 

tion. What if, under a system of false pretension, of unworthy 
contrivance, of tortuous policy winding itself into every opening 
however foul and crooked, a physician should attain a certain 
amount of temporary success ; what if, in opposition to better 
knowledge, he should trim his sail to some popular breeze, and, 
raising the flag of homoeopathy, Thompsonism, or some other 
folly of the day, should glide out of the obscurity, in which he may 
hitherto have been concealed, into a short-lived notoriety; what if, 
abandoning all regard to decent appearance, he should hang out 
the meretricious allurements of the vender of secret nostrums, and 
gather wealth and splendour by the wages of his professional pros- 
titution ; is all the success, or ten times the success which he may 
meet with in the world, the slightest remuneration for that self- 
loathing with which he must look into his own corrupt interior, for 
that pity or scorn with which he is conscious that he is regarded 
by his former professional brethren, and by the most enlightened 
individuals of the community which he disgraces ? But I wish 
not to be misunderstood. It is only those who sin against better 
knowledge that are here referred to. Conscientious convictions 
should be respected, even though based upon ignorance and delu- 
sion ; and, so prone is the human intellect to every kind of aberra- 
tion, that we may readily admit the possibility of an honest con- 
version from orthodoxy in medicine to the wildest creed that ever 
sprang from a deluded imagination. We can even suppose that an 
educated physician may become a convert to some Mormonism in 
medicine, and, under the scourge of public contempt, feel all the 
consolations of a martyr. For such delusions there should be no 
other feeling than compassion, as there is no other cure than time. 
That the public should suffer is a misfortune ; but this is equally 
the result of ignorance and delusion on their part, and is probably 
one of the means, in the wise course of Providence, for the eradica- 
tion of error, and the ultimate diffusion of light and truth. 

Imbued with the true spirit of the profession, you will be ele- 



368 A.\ ADDIM'SS TO THE MEDICAL GRADUATING CLASS. 

vated above all these sources of error in conduct and judgment. 
In shaping your own course, you will always have reference to the 
honour of your calling, which, as it is based upon truth, and aims 
only at the good of mankind, will, in your relations with one 
another, with your patients, and with the world, have a tendency 
to keep you within those great ethical rules which have the same 
origin and object. Under this influence, you will, in every doubtful 
case, ask yourselves the question, whether the proposed course will 
conduce to peace and harmony among physicians, to the welfare 
of those intrusted to your charge, to the general good of society, 
and to the due estimation and consequent influence of your profes- 
sion among men ; and, according as this question is answered affirm- 
atively or negatively, you will unhesitatingly .advance or recede, 
even though your apparent immediate interests may suggest a dif- 
ferent conduct. Nor, in the end, will you ever have occasion to 
repent the seeming sacrifice. The instances are few, indeed, in 
which perseverance in a strictly honourable professional course, 
with a due degree of enterprise and industry, has not led to ulti- 
mate success ; while, in our voyage through life, we are constantly 
passing the wrecks of hopes once as fair as our own, stranded upon 
the shoals of temporary interest and disreputable expedient. 

We have thus, gentlemen, in taking our last farewell of you as 
a body, endeavoured to leave with you, as a parting gift, some 
thoughts for your professional guidance, which I have no doubt 
will be received in the same kindly spirit in which they are offered. 
It gives us great pleasure to present you, in addition, with the 
acknowledgment of our entire satisfaction with your deportment 
and exertions during the past winter, and with the general success 
which has crowned your efforts. From the peculiar relations of 
our school towards the country, and towards the sister schools 
which have sprung up everywhere in such rapid succession, it has 
happened that a progressive improvement has been observable in 
the classes of graduates who have annually left our walls ; and I 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 369 

am authorized by my colleagues to say, as their united sentiment, 
that the present class constitutes no exception to the general rule. 
We have, indeed, been exceedingly gratified by the result of the 
recent examinations, which, though assuredly not less rigorous than 
those of preceding years, have evinced a degree of preparedness on 
the part of the candidates, which has been equalled on no former 
occasion within our recollection. We send you forth, therefore, 
with entire confidence that your future course will be creditable to 
yourselves, and to the institution whose honours you bear. It is 
scarcely necessary to say that, wherever you go, you will carry 
with you our warmest sympathies. We have a personal interest 
in your conduct and success. Scattered over every part of the 
country, you will be the standard by which men will judge of the 
merits of the school in which you were instructed; and we are 
willing to abide the test. Whether your present grade of charac- 
ter and professional attainment, or the position you are hereafter 
to occupy, be regarded as the criterion, we are willing to rest our 
claims to public approval upon the result of an impartial judg- 
ment. Perhaps, the very consideration that the reputation of your 
alma mater is in some measure in your hands, may add a generous 
and effective impulse to the other motives which urge you onward 
in the course of honourable exertion. There is no purer source of 
satisfaction, in this world, than so to stand in the eyes of men as 
to reflect back honour upon those to whom we have been in any 
degree indebted for early culture. 

But, gentlemen, we must bid you farewell. Crowds of thoughts 
and emotions press upon us at this moment of separation, which 
time is wanting to express. We must content ourselves with refer- 
ring to your own good sense for all of counsel, and to your own 
hearts for all of feeling that we are compelled to leave untold. 
May the divine blessing attend you throughout this life, and follow 
you in the life to come. 

24 



ADDRESS III 



DELIVERED TO THE GRADUATING CLASS AT THE COMMENCEMENT, 
HELD MARCH 29th, 1856. 



Gentlemen : — 

Your state of pupilage is now passed ; and, by the solemn act 
just performed, you have been admitted into full membership in 
the great medical body. We, your late teachers, congratulate 
you on this fulfilment of your wishes, and receive you heartily into 
professional brotherhood. Custom, as well as our own feelings, 
prompts, along with the most kindly greetings upon the occasion, 
a few words of friendly suggestion, such as age and experience, 
and an interest scarcely less than parental, may perhaps be ad- 
mitted to warrant. 

But first we have the pleasing duty to perform, of awarding to 
merit its just meed of commendation. The Faculty are united in 
the statement, that with no class which has ever assembled under 
their tuition, have they had better reason to be satisfied, whether 
in relation to general demeanour, or industrious application to 
study. For some years, it has seemed to them that, in both 
these respects, a gradual advancement in successive classes has 
been observable; and the present assuredly affords no example 
of retrogression. It is due to the students of medicine who 
now annually flock to our city, that we should perform our part 
towards placing them erect, as they deserve to be, in public 
(3T0) 






AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 371 

opinion. There is, perhaps, still lurking in our community some 
residue of that old prejudice, if prejudice it was, which regarded 
the young devotee of medicine as a little given to wildness ; as 
disposed to qualify the sobriety of his daily routine by an occa- 
sional effervescence of conduct, not strictly in accordance with the 
rules of law and good order. Now, whatever may have been the 
truth in relation to past times, I do most sincerely express the 
conviction, that the students of the present day are characterized 
by a regard for the proprieties of life, even beyond what is gene- 
rally observable of young men of the same age ; and that an equal 
number of any other calling whatever, not bound by peculiar reli- 
gious obligations, collected under the same circumstances of free- 
dom from restraint, would offer more frequent occasion than they 
for complaints of irregularities, and various indecorums. The 
very nature of their position has led to this result. With the in- 
crease of professional competition, and the widening of the circle 
of medical knowledge, there has been an increased necessity for 
exertion; and the student feels that, to secure the attainment of 
his objects, he must work more, and amuse himself less than his 
predecessors. That he does labour diligently ; that the scholastic 
hall and the quiet chamber are more familiar to his experience 
than the theatre and the bar-room ; that his feasting is mainly at 
the board of knowledge, and his intemperance that of study and 
not the bowl; are sufficiently evinced by the contrast between 
what he is in face and person when he arrives, and what he be- 
comes before departing. With this contrast I have often been 
struck. Fresh from active pursuits, he comes ruddy or em- 
browned, full of health, spirit, and physical energy. Five or six 
months of confinement and hard mental work follow ; and, when 
he goes, he carries with him not unfrequently pallid cheeks, a 
wasted body, and a spirit worn by anxieties and fatigue. How 
often have I been consulted for dyspeptic symptoms, headache, 



372 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

mental dejection or disquietude, and various nervous disorder, for 
which I have been able to hold out the termination of the course 
of study as the only cure ! It is no dispraise to you, young gen- 
tlemen, to appeal to your present looks as confirmatory of what I 
have said. If your fair friends- do not see in you all the bloom 
and rotundity which may please the mere physical eye, I will ven- 
ture to pay them the compliment to believe, that they see and 
appreciate the deeper intellectual accomplishment, which has been 
gained at the expense of the outer man. Let them look on you 
some twelve months hence; and, unless my observation in similar 
cases has been strangely fallacious, they will discover no deficiency 
of health and manly vigour. But, with my opinion of the sex, I 
would infinitely prefer, to the mere admiration of external form, 
that feeling of inward approval, of respect for labours achieved 
and honours won by meritorious effort, which woman is so apt to 
evince, and which speaks so strongly of her own pure and noble 
nature. If, then, I may be permitted to turn for a moment from 
you to those who have honoured you and us with their presence 
this morning, I would beg of them to join us in the effort to give 
the character of the medical student that place in general estima- 
tion which it merits. They will thus not only be doing an act of 
justice, but will contribute to the still further elevation of that 
character, by offering to those who may hereafter come among us 
the strongest inducement to support and improve the reputation 
which their predecessors left them, and sedulously to avoid every- 
thing which might fix the least stain upon it. 

But let us return from this little digression into which the occa- 
sion tempted us, and set out upon a brief anticipatory journey 
through the future that lies before you. The dreamer crowds the 
events of years into a few minutes. Let us dream ourselves on 
the path of life together. Perhaps we may be able, by a rapid 
course, to reach the end of it before we part. Perhaps, too, some 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 3*73 

thoughts may spring up, some hints be gathered by the way, which 
may remain when the dream is over, and serve a useful purpose on 
the real journey which is to follow. 

Your first steps are those of exultation and gladness. You have 
aspired, have laboured, have denied yourselves, and have won. 
The goal is reached ; the prize is in your hands. And now for 
home, sweet home ! Ah ! the delight of returning once more to 
assured affection. The father's benignant greeting ; the deep ten- 
derness of the mother's eye ; the mingled smile and tear of the 
sister; the boisterous glee of the young brother; and, it may be, 
the warm blushes of one not less loving or beloved ; what is there 
in life more delicious? All nature exhales sweets for you in this 
morning of your journey. Earth, air, and water; the field and 
the stream; man and his works; and lovely woman, the crown 
and the charm of all, spread for you the feast of enjoyment every- 
where upon your way. Soul and body expand under these genial 
influences. The sickly hue and languor of study give way to the 
bloom, the vigour, and activity of health. 

But this stage of excitement passes. Man was not made for 
self-indulgence. Your long labours have gained for you a brief 
period of exuberant gratification. It is the reward of toil. But 
nature has paid her dues, and in her turn puts forward the inevit- 
able claim, either labour or suffering. We have been gifted with 
powers mental and bodily. These powers were given to be used ; 
and the penalty for not using them is pain. The limb always at 
rest suffers with an aching void ; the body unexercised is punished 
with the tortures of dyspeptic and nervous disorder; and mental 
inertness is almost surely attended with the horrors of ennui. But 
nature is not unkind ; though she exacts labour under the penalty 
of suffering, she repays it with enjoyment. Every faculty has con- 
nected with it a chord, that incessantly vibrates pleasure when the 
faculty is duly exercised. Paradoxical as it may seem to you, I 



374 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

believe that the purest and most lasting gratification in this world, 
is that which waits upon the full and even laborious exercise of 
each faculty to its legitimate end; whether of the bodily powers to 
their ends, the intellectual to theirs, or the moral, including the 
conscience, to theirs. The commencement of laborious efforts may 
be distasteful; there may be frequent occasions for painful self- 
denial ; and the firmest control of the passions may sometimes be 
necessary to restrain their irregular tendencies; but a balance 
fairly struck will show a great preponderance in the scale of 
enjoyment. 

The point in your life-journey that we have now reached, is one 
at which you are called on for a decision, upon which must turn 
the happiness of your whole future. Too many, intoxicated by 
the brief draught of pleasure, and indisposed to relinquish it, 
attempt to supply the first vague uneasiness of satiety, and to 
quiet the troublesome calls of conscience, by the aid of artificial 
excitement, of the short joys of intemperance, the delirious excesses 
of the passions, or the scarcely less noxious influence of mental 
dissipation. They fall off by the way. Some are lost, and heard 
of no more. Others linger out a miserable existence, with health 
destroyed by excess, and minds dead to enjoyment, useless to the 
community, and a burden to themselves. A few are arrested in 
their downward course of dissipation, vice, and wretchedness, and 
succeed in regaining the starting-point, after long and uncertain 
struggles, to begin anew the great work of life, with powers 
rusted by neglect, and feelings blunted by premature indulgence. 
Oh ! gentlemen, may no one of you incur this sad fate ! May 
yours, one and all, be the choice of prudence and wisdom ! 

Most happy is it for many of you, that you are not overloaded 
with this world's treasures ; that necessity will come in aid of your 
better resolutions, and urge you on in the right path. There are 
few misfortunes greater for a young professional man than to be 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 375 

independent of the world. The temptations to self-indulgence are 
almost too strong for those not aided by long habit to resist. I 
have greater respect for no man than for him, who, with all the 
pleasures of the world at his command when young, holds a firm 
rein over his propensities, and mounts the laborious ascent of 
honour by his own determined efforts. He richly merits whatever 
eminence he may gain. But, in the mean time, those of you who 
are not exposed to his temptations, instead of repining at your 
lot, should congratulate yourselves on your exemption, and on the 
greater probability it affords you of one day attaining all that an 
honourable ambition can hold out as desirable in this world. Be 
assured that, if you consult those who have preceded you, and 
reached the eminence at which you aim, the great majority of them 
will tell you, that one of their greatest causes of thankfulness is to 
have escaped the dangers of wealth, and even of competence, in 
early life. 

Well, gentlemen, you are resolved to struggle manfully for pro- 
fessional success. But, you may ask, how are we to struggle when 
there is nothing for us to do ? Now, here again is a blessing in 
disguise. One of the worst results for you would be to rush at 
once into the full tide of business. Employed in practical duties, 
you would have no time, and probably no disposition for self-im- 
provement. You would be arrested at the point of progress at 
which you stand ; and, though a certain amount of income, and a 
certain professional position might be attained ; yet these would 
fall far short of the highest ; and you might, as you advanced in 
life, have the mortification to see yourselves outstripped by those 
who had, in their early career, enjoyed and availed themselves of 
the opportunity of enlarging their store of professional and general 
knowledge. The first few years of a physician's life, during which 
he is awaiting the slow incomings of a regular business, are a pre- 
cious opportunity, upon the proper use of which much of his sub- 



SIC) AN ADDRESS TO THE MEDICAL GRADUATING CLASS 

sequent prosperity must depend. In the schools, and the regular 
course of study, you have acquired the elements of your profession. 
You have had a foundation laid, upon which you are yourselves to 
build. Instead, then, of folding your arras in listless idleness, or 
dissipating your time in irrelevant pursuits, or repining in moody 
inertness over the slowness of your success, bend your energies to 
the acquisition of knowledge and skill; study the records of the 
past ; by a close observation, make the experience of your older 
contemporaries your own ; seize every opportunity which the suf- 
ferings of the destitute may afford you of improving yourselves, 
while you extend aid to them ; even wander out occasionally into 
the regions of general literature, and garner up thoughts, facts, 
and feelings, which may tend to enrich and adorn your mental 
structure, and give your whole character, both in itself and in the 
eyes of the world, the amplest development and fairest propor- 
tions. Depend upon it, your labour will not be thrown away. 
Opportunities occur to all men. They occur in vain only when 
there is a want of disposition or qualification to make use of them. 
Be prepared to meet the advances of fortune, and she will be sure 
to befriend you. The great danger is of premature discourage- 
ment. Many a professional man has thrown himself away, when 
approaching success was almost within sight; when it was about 
to turn the very corner, upon which his despairing eye had just 
taken its last look, before his departure into other scenes and 
struggles. 

Let me tell you of another rock on which young men too often 
split. It is the rock of false pride. Nothing is more disgusting 
than an over-pushing disposition, resolved to gratify itself at any 
sacrifice of honourable feeling, independence of character, or regard 
for the rights of others. But distaste for such an exhibition does 
not justify that absurd pride, which shuts itself up in its own shell, 
and expects the world to approach, and beg that it would come 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS, 3T7 

forth, and warm itself in the sunshine of its favour. The world 
has a right to expect that we should make known our ability to 
serve it; and he who neglects all honourable opportunities of 
favourably impressing the community in which he lives, has no 
right to expect its aid in the furtherance of his own purposes. 

I repeat that, with qualifications improved by culture, with all 
due personal efforts, and with a proper perseverance, you can 
scarcely fail of success in the end. It may be that all of you have 
not resources upon which you can rely until success may come. 
But there are honourable means by which an energetic young man 
may supply the deficiences of professional income ; and rigid per- 
sonal economy, with a prudent avoidance of premature responsi- 
bilities, will always enable him, if in health, to supply his essential 
wants, if not exactly on the spot which he might prefer, yet in 
some part or another of this vast country. Determine only that 
you will not live on the future, that you will not allow yourselves 
to enjoy pleasures that you have not earned, that you will not fall 
into the fatal error of supposing yourselves entitled to begin life, 
with all the comforts and indulgences which your parents may 
have won for themselves before its close; determine thus, and I 
can almost guarantee you against ultimate failure. 

But should your expectations be disappointed, should it seem 
evident to you, after due patience, whether with or without fault of 
your own, that satisfactory success in your profession is unattain- 
able ; do not, I beg of you, in your despair, descend into any de- 
grading practices. Leave the whole ground of quackery free to 
ignorance and imposture, without competition from you. Some 
regularly educated physicians, I say it with shame and sorrow, 
have deserted the banner under which they had enlisted, and 
thrown themselves recklessly into the empirical ranks. They may, 
in some instances, have received the pecuniary recompense they 
sought for ; but I need not tell you of the consciousness of merited 



378 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

contempt, and of the self-loathing which fester under the gilded 
exterior of their fortunes. Ignorance may plume itself upon suc- 
cess in the stratagems and impositions of quackery; but intelli- 
gence never can sink to that miserable level, without an inward 
contempt and scorn of the baseness, which, brazen-faced as it may 
be before the world, will forever cling to the innermost conscience 
with a vulture-like tenacity. Anything but this, gentlemen ! If 
you cannot succeed regularly in your profession, leave it; seek 
your fortunes in some other honourable or honest calling; become 
lawyers, merchants, manufacturers, farmers, mechanics, labourers; 
if necessary, stitch, or cobble, or dig for a living; nay, starve, if it 
must be so ; but never turn to quackery. There is, however, no 
danger. You cannot be guilty of the baseness. I do not know 
whether an apology is not due to you for the mere hypothetical 
supposition. 

We will take it for granted that you have succeeded in your 
profession. You have merited and gained the confidence of your 
neighbours. Hundreds look to you as the guardians of their 
health, their main earthly hope in the agonies and dangers of dis- 
ease. Here is an immense responsibility. The sacred ark of 
human life has been intrusted to your keeping. You are an 
anointed priesthood in its service. How important that your 
hands should be clean, your hearts pure, and your souls deeply 
reverent in your ministrations. This, gentlemen, is the light in 
which you should habitually view your profession ; not as a mere 
business ; not as a mere avenue to competence or wealth ; but as 
a covenant with the Most High, by which you are devoted, soul 
and body, to the good of your fellow-men, so far as that may de- 
pend on life and health. The ox, however, must not be muzzled 
that treadeth out the corn. You have a right to expect from 
your labours a support equal to the dignity of your calling. But 
this should be looked on as incidental; as an important, or even 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 379 

essential accessory, if you please; but not as the great end and 
aim. He who enters the medical profession with a mercenary 
spirit, will almost necessarily come short of its highest require- 
ments. Aiming at the appearance rather than the reality of skill, 
he will think more of the impression he may make on others, than 
of a proper understanding and treatment of the disease. Where 
nothing is to be gained but the consciousness of duty fulfilled, he 
will be little apt to spend time and labour, which might yield him 
more if applied elsewhere, or at least would be abstracted from his 
pleasures. For the frequent self-denial, the steady devotion of 
thought and energy, the unwavering guard over his precious 
charge, as well when unseen as when seen of men, which charac- 
terize the right spirited practitioner, he has no sufficient induce- 
ment. He will be almost necessarily more or less superficial. He 
never can be the true model physician. Just in proportion as 
medicine is cultivated in the mercenary, or in the pure professional 
spirit, will be its decay or advancement in efficiency, real dignity, 
and acceptance with God and man. 

Be this, then, gentlemen, your great care — to establish and culti- 
vate proper notions of your high calling ; to fix in your innermost 
convictions the truth that you are engaged in a great mission, and 
responsible to him who sends you forth for its due discharge. This 
feeling will be the best preservative against every temptation; 
against the solicitations of indolence or pleasure ; the hateful sug- 
gestions of envy ; the unkindly influence of opposing interests; and 
the irregularities of all sorts that spring up, like noisome weeds, in 
the rotten soil of an avaricious or grasping spirit. 

Time is not left to sketch that round of duties, of things to be 
done and avoided, of feelings to be cherished or subdued, of rela- 
tions to be preserved with the public, the sick, and your medical 
brethren, which constitute the ethics of your profession. But they 
all fall within the great general principle already referred to. Get 



380 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

the true professional spirit, and all else that is needful or desirable 
will be added unto it. Nevertheless, you will find great aid from 
the study of those written rules, which the wise and good among 
your predecessors have deduced from an ample experience, culti- 
vated judgment, and enlightened conscience. Such a code of ethics 
has been adopted by the great national medical association, and 
published as a guide to the whole profession. I would urge on 
you to study it thoroughly, and make its rules the laws of your 
professional life. Based, as they are, upon sound morals and a 
lofty feeling of honour, they cannot but lead, if duly observed, to 
the elevation of our calling in usefulness, dignity, and respect, 
and consequently to the personal advantage of every conforming 
member. 

Before coming to the closing scene, let us picture to ourselves 
your position, when, in the middle or decline of life, having strug- 
gled manfully through early difficulties, you are firmly fixed in the 
confidence of the community, with a consciousness that you have 
lived up to the capacities with which heaven has endowed you, and 
endeavoured, so far as is compatible with human infirmity, to make 
yonr conduct conform with your convictions of social and profes- 
sional duty. Let us see whether there is not something in such a 
position worthy of the aspirations of the young, and calculated to 
encourage them in a course of honourable effort, and virtuous self- 
denial. 

You are in the midst of those who feel themselves indebted to 
you, either in their own persons, or that of their nearest friends, 
for the continuance of life and health, or associate you affection- 
ately with the memory of lost relatives, whose sufferings have been 
alleviated, and their last moments cheered by your kind and inde- 
fatigable attentions. If a soured temper, or perverted heart, may 
occasionally seek satisfaction in misinterpreting or misrepresenting 
your best exertions, it is only an evil which is incident to humanity 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 381 

in every station ; a slight mixture of bitterness in your cup, which, 
though not agreeable to the taste, may have an invigorating influ- 
ence on the mental health. No profession probably offers less 
occasion for unkindly feelings. You thwart no interests in your 
progress ; your success is not attained at the expense of others ; 
yours is not the reckless course which crushes under its iron wheels 
whatever of respect, competence, hope, enjoyment, or any other 
pleasant or valuable thing, may lie in its ambitious way. Your 
aim is always the good of others; your triumph is also theirs. 
Wherever you go, you scatter hope, or joy, or consolation. Not 
only affection, but respect and esteem attend you. Social influ- 
ence, and the power to do good in other walks than the purely 
professional, are yours. The comforts of life, and not unfrequently 
even its elegancies and superfluities, are at your command. If 
without political power and station, it is only because these are 
incompatible with your pursuits, habits, and tastes. The highest 
in the world deem themselves not dishonoured by your association 
and friendship. Your name and character are a rich inheritance 
for your descendants for generation after generation. Is not this 
a position fully worth all its cost ? Is it not a sufficient compensa- 
tion for the early labours, the trials, the patient waiting, the watch - 
ings, fatigues, anxieties, for all, indeed, but the awful responsibili- 
ties of a physician's life ? For the burden of these responsibilities, 
an approving conscience, and the trembling hope that the most 
merciful may overlook the shortcomings of human weakness, are 
the only adequate recompense. 

And now, gentlemen, we have come to the last scene of life. 
This is usually looked on as an occasion from which the thoughts 
are to be turned away as from some fearful object, the contempla- 
tion of which is calculated to throw a shade of gloom over every 
present and coming enjoyment. But this is a great mistake. Death 
is inevitable ; and it is cowardice not to be willing to look it steadily 



382 AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 

in the face. In the physician especially, whose path it constantly 
crosses, who cannot hope to exclude its presence, it is extreme 
weakness to shut the eye against it, and thus endeavour for a brief 
space to dream of an impossible exemption. We should accustom 
ourselves to regard it firmly, to strip it of imaginary terrors, to see 
in it whatever there may be of good or of evil, and calmly to pre- 
pare ourselves accordingly. This is the part not only of religion, 
but of philosophy. An habitual feeling of the uncertainty of life, 
in the properly constituted mind, is one of the best safeguards 
against all irregularities of thought or deed, and the surest guide 
back to the right path after any temporary wandering. Let us 
then cherish this feeling. We shall find it incompatible with no 
innocent pleasure; we shall even find it a consolation in trouble; 
and, should misfortunes overwhelm us, we shall see in it at least 
one star beaming through the tempest, and betokening a clear sky 
beyond. To the duly prepared mind, death, come when it may, 
whether in the morning, the noon, or the evening of life, is no evil. 
If in the midst of joys, it saves us from the sorrows that surely 
follow; if in trouble, it gives relief; if in a course of honourable 
usefulness, it embalms our memory sweetly in the common mind ; 
if at the close of a long and upright career, it comes as a kind 
friend, to free the spirit from the burden of flesh, which can no 
longer serve it as an instrument of action or enjoyment. May 
yours, my young friends, and may ours be the lot, when this mes- 
senger shall call, to be prepared to follow, with the calmness of 
a peaceful conscience, and the well-grounded hope of a happy 
futurity ! 

But, gentlemen, you may recollect that we have been occupied 
by a dream of life. We are now awake again, and back in the 
present. This is probably the last occasion upon which we shall 
all be in one place together. To-morrow ; and you will be scat- 
tered towards every corner of our common country. Allow me to 



AN ADDRESS TO THE MEDICAL GRADUATING CLASS. 383 

express the sincere hope, that you will carry with you kindly recol- 
lections of your teachers, and your alma mater; and that, in the 
varied experience that awaits you, your thoughts will now and 
then wander pleasingly back to these scenes of your young labours 
and success. Be assured that, wherever you may go, and whatever 
may be your lot, you will have with you our warm sympathies, and 
our zealous wishes for your welfare, present and eternal. 



BIOGRAPHICAL MEMOIRS. 



25 



A MEMOIR 

OF 

THE LIFE AND CHARACTER 

OF THE LATE 

JOSEPH PARRISH, M.D., 

READ BEFORE 

THE MEDICAL SOCIETY OF PHILADELPHIA, 

OCTOBER 23d, 1840. 



The office assigned me by the Medical Society of portraying 
the life and character of the late Dr. Joseph Parrish, is a trust 
most grateful to my feelings. To be appointed to speak of such 
a man before such an audience, is a mark of respect which no one 
could fail to value ; but a still higher source of gratification, in the 
present instance, is the opportunity afforded me of giving utter- 
ance to those sentiments of esteem and warm affection which I 
ever cherished for the deceased, and which I still cherish for his 
memory. 

I do not propose to enter into much minuteness of biographical 
detail. This is forbidden by the necessary brevity of an address 
like the present, and by the nature of the occasion, which calls less 
for a narrative of the ordinary incidents of life, than for the just 
representation of a medical character, pleasing by its beautiful 
traits, and useful as a rare pattern of what is most praiseworthy 

(387) 



388 A MEMOIR OF DR. JOSEPH PARRISH. 

in our profession. The man, however, was in Dr. Parrish so inti- 
mately blended with the physician, his professional excellencies 
flowed so directly from the qualities of his heart and intellect, that 
no portrait of his medical character would be recognized, which 
should not also present the striking lineaments of his moral nature. 
In the following sketch, therefore, having offered some notices of 
his parentage, education, and general course of life, and especially 
such as may illustrate his character, or may appear to have had 
any influence in its formation, I shall endeavour to revive in your 
recollection his distinguishing moral and intellectual peculiarities, 
and then to trace those qualities as a physician-and medical teacher 
which rendered him so extensively useful, and so highly esteemed 
in this community. 

Dr. Parrish was descended from one of the early settlers of this 
country. His great-grandfather, John Parrish, who was a native 
of England, though of Dutch extraction, commanded a merchant 
vessel trading to the Chesapeake, and afterwards became surveyor- 
general of Maryland, where he took up considerable tracts of land, 
on a portion of which some of his descendants still reside. He 
perished in a storm by which he was suddenly overtaken while in 
a small boat on the Chesapeake, returning from a visit to a ship 
sailing up the Bay. The grandfather of the Doctor, also named 
John Parrish, died in possession of a landed estate, on which a 
part of the city of Baltimore now stands. This, however, was lost 
to his family, though the title to it is said never to have been sur- 
rendered; and application was made, at a comparatively recent 
period, to the subject of the present memoir, to join in an effort for 
its recovery, with the assurance that there were good grounds to 
hope for a successful result. The determination of Dr. Parrish, on 
this occasion, was strikingly characteristic. He promptly declined 
the proposition, on the ground that no advantage which could 
accrue to himself or his family would counterbalance the uncer- 
tainty, inconvenience, and positive distress into which numerous 



A MEMOIR OF DR. JOSEPH PARRISH. 389 

individuals might be thrown by the agitation of the subject, who 
had honestly acquired their titles, and were now relying on them 
with undoubting confidence. 

Isaac Parrish, the father of the Doctor, was one of a consider- 
able family, who, upon the death of their mother, were left almost 
destitute, and were sent to Philadelphia, in compliance with her 
request, to be placed under the care of some near relatives of hers 
residing in this city. He had been intended by his parents for a 
physician ; but the means for carrying their intention into effect 
were found to be wanting after their death ; and he was placed as 
an apprentice with a very respectable hatter, whose daughter he 
afterwards married. Honest, frugal, and industrious, he succeeded 
well in his business, supporting and educating a numerous family, 
and retiring, in the decline of life, upon a decent competence, with 
the respect of all who knew him. He was especially esteemed in 
the Society of Friends, of which he was a consistent member, and 
in which both he and his wife held highly respectable stations. 
The reward of a virtuous life has seldom been more happily exem- 
plified than in the old age of this venerable couple. They lived 
sixty-six years together in unbroken harmony, and died within a 
short period of each other at a very advanced age. Their last 
years were cheered by the affectionate attentions of their few re- 
maining children. They who enjoyed the familiar intimacy of 
Dr. Parrish cannot but vividly remember his beautiful deportment 
towards his aged parents. The youngest of eleven children, of 
whom the greater part died early, he was their joy and consolation 
throughout life ; in youth obedient, in manhood affectionate and 
attentive, and, when the weakness of old age came upon them, all 
that was tender and respectful ; so that, when he finally closed the 
eyes of his venerable father, he could say with sincerity that he was 
not conscious of having ever offended him. 

Dr. Parrish was born on the 2d of September, 11^9. He re- 
ceived a good English education, and was taught Latin at the 



390 A MEMOIR OF DR. JOSEPH PARRISH. 

Friends' school in Fourth Street, at that time in considerable 
repute as a place of instruction in the learned languages. He 
afterwards paid some attention to French, and still later in life 
to the Hebrew, which he cultivated exclusively in reference to the 
study of the Bible. He could not, however, be said to have a 
decided literary turn ; and, though he took care to qualify himself 
well as a physician by a somewhat extensive course of medical 
reading, and, in the few leisure intervals of a very active life, occa- 
sionally perused works of general interest, yet he was indebted, as 
well for his professional skill as for his extensive knowledge of 
men and things, less to books than to an extraordinary faculty of 
observation, and a memory unusually tenacious of facts. He never- 
theless always attached great importance to mental culture ; and, 
in his last will, while giving directions in relation to the education 
of his children, he expresses the sentiment, that he would rather 
a child of his should expend every cent of his inheritance in the 
acquisition of knowledge, than that he should arrive at maturity, 
in possession of a large estate, without the advantages of scientific 
attainment. 

The moral and religious education of Dr. Parrish was of the 
mpst guarded kind. He was brought up in strict conformity with 
the principles and habits of the Society of Friends, and early in 
life received strong religious impressions, which preserved him in a 
remarkable degree from the temptations of a warm and lively tem- 
perament. From some notes which he left behind him, made about 
the commencement of his medical studies, it appears that, even in 
youth, he was under the habitual guidance of that inward principle, 
in which the Friends recognize the Divine Spirit operating upon 
the mind, and the reality of which is one of the prominent points 
of their religious faith. Upon this subject I shall have occasion 
to speak more fully hereafter ; as there was scarcely an important 
act or event of the life of Dr. Parrish, which did not receive im- 
pulse or modification from his settled convictions in relation to 



A MEMOIR OF DR. JOSEPH PARRISH. 391 

this monitor within him; and to leave it out of view would be to 
present an imperfect, if not an inaccurate picture of his character. 

But, while thus moral according to the strictest rules of his self- 
denying sect, he indulged freely in the innocent sports and recrea- 
tions of boyhood, and was distinguished among his companions by 
his skill in various athletic exercises. He was a swift runner, a 
good swimmer, and an excellent skater. In the facility, grace, and 
rapidity of his movements upon the frozen surface of the Delaware, 
few if any of his contemporaries surpassed him. This accomplish- 
ment he carried with him into manhood ; and it is related of him 
when in middle age, and in full reputation as a physician, that, 
having occasion to make a professional visit, during winter, upon 
the opposite bank of the river, he accepted from a friend the loan 
of a pair of skates, and astonished the spectators by some of those 
complicated and graceful evolutions which have now become almost 
an affair of tradition among us. His aversion to confinement and 
fondness for the free and fresh air never forsook him. Throughout 
the whole course of his life, he could not tolerate a close and heated 
apartment, slept always in summer with his windows up, and even 
during illness found a degree of coolness essential to his comfort, 
which was almost hazardous to his attendants. There is no doubt 
that this personal predilection influenced greatly his course of prac- 
tice ; and, long before the profession generally, in this place, were 
prepared to adopt the plan, he had introduced into the treatment 
of various diseases a system of exercise, exposure to cool air, and 
free indulgence in cool and refreshing drinks, which, to the great 
comfort of the patient and success of the physician, have at length, 
in many instances, superseded the old system of drugs, warm bev- 
erages, and confinement. 

His youthful partialities were strongly directed towards the study 
of medicine ; and those among his early friends who afterwards wit- 
nessed his extraordinary professional success, took pleasure in re- 
calling many evidences which he had exhibited, even in boyhood, 



392 A MEMOIR OF DR. JOSEPH PARRISH. 

of a natural turn and natural qualifications for this pursuit. He 
was fond of reading upon the subject of diseases, exhibited an 
instinctive disposition to visit and nurse the sick, and, in the ab- 
sence of other modes of indulging his propensity towards the heal- 
ing art, is said to have exercised his skill upon the inferior animals, 
and to have exhibited some dexterity in the treatment of their 
fractured limbs. The fears of his parents, however, were for some 
time an obstacle to the gratification of his wishes in the choice of 
a profession. They were unwilling to expose the strictness of his 
religious principles, the purity of his morals, and the simplicity of 
his habits and feelings unnecessarily to the seductions of the world; 
and entertained a belief, much more common at that time than at 
present among the Friends, that a strict observance of their peculiar 
views and customs as a sect, was incompatible with the various 
temptations to which the student of medicine was subjected. Re- 
specting, though not acquiescing in these parental fears, he surren- 
dered his own wishes, and entered into the shop of his father with 
the view of qualifying himself for conducting the business of a 
hatter, rather, however, in a mercantile than a mechanical capa- 
city. In the most brilliant period of his subsequent career, he 
never had the weakness to look back with regret upon the occu- 
pation of his early life, or the remotest wish to conceal it from 
others. On the contrary, he always entertained great respect for 
mechanical pursuits, and considered a descent from honest and 
worthy parents, however humble their station, as a juster ground 
of self-congratulation than the highest splendour of ancestry with- 
out the accompaniment of virtue. 

In this position he continued till his twenty-second year, when, 
as his own inclinations remained unaltered, and the objections of 
his parents had yielded to more mature reflection, and perhaps also 
to increased confidence in his stability, he felt himself at liberty to 
engage in the study of medicine, and accordingly entered as a pri- 
vate pupil into the office of Dr. Wistar, at that time Adjunct Pro- 



A MEMOIR OF DR. JOSEPH PARRISH. 393 

fessor of Anatomy and Surgery in the University of Pennsylvania. 
The advice and example of the late Dr. Samuel Powell Griffitts, 
who was in great esteem as a physician, and was at the same time 
a strict and conscientious Quaker, had considerable influence in 
bringing about this result. For this and numerous other friendly 
offices of that gentleman in promoting his professional interests, 
Dr. Parrish always entertained the most grateful feelings ; and a 
friendship sprang up between them, which was fruitful in mutual 
service, and continued without abatement till the death of Dr. 
Griffitts. 

The mode of conducting medical education was in those times 
very different from that which now prevails in this city. Physi- 
cians supplied medicine as well as advice ; and it was among the 
duties of the student to put up the prescriptions of his preceptor 
as they were brought to his office, and even to carry out the prepa- 
rations himself in cases of peculiar urgency. I have often heard 
Dr. Parrish speak of the errands on which he was dispatched, by 
day and by night, over all parts of the town, conveying the mes- 
sages of his preceptor, and distributing medicines among his pa- 
tients. The student also not unfrequently visited the sick, nursing 
them, sitting up with them at night, and occasionally affording his 
advice upon emergencies when immediate access could not be had 
to the principal. In relation to his reading, he usually received 
some general directions from his preceptor, to whose library he had 
access ; but was seldom subjected to a routine of study and close 
examinations such as are now common, and was therefore more or 
less deficient in that precision of elementary knowledge which char- 
acterizes the student of the present day. I am fully convinced that 
the plan of education which now prevails is the most efficient ; as 
it insures a good foundation, upon which experience may subse- 
quently build, and which, if wanting in the outset, is seldom after- 
wards obtained. But there were some advantages in the old mode, 
and among these were greater originality and independence of 



394 A MEMOIR OF DR. JOSEPH PARRISH. 

thinking, greater practical facility arising from frequent intercourse 
with disease, and a more thorough acquaintance with medicines 
and the modes of preparing them. The peculiarities of his educa- 
tion were to be traced in the subsequent course of Dr. Parrish ; 
and to this origin we may ascribe the strong bent of his mind 
towards practical observation and experience, in preference to 
abstract reasoning and theoretical disquisition in medicine. He 
certainly availed himself fully of all his advantages, and, by his 
industry and close attention, as well as by a congenial goodness 
of heart and obligingness of disposition, succeeded in gaining the 
esteem and entire confidence of his preceptor, who loved him as a 
younger brother, and treated him throughout life with a kindness 
which gained in return his whole affections. Those of you who 
have listened to the medical lectures of Dr. Parrish, cannot but 
recollect how frequently and respectfully he quoted the sentiments 
of his old master, as he was wont to call him, and how unreservedly, 
on all occasions, he expressed his admiration of the character, and 
his grateful sense of the favours of that good and great physician. 
He received his degree of Doctor of Medicine in the University 
of Pennsylvania in June, 1805, having written an inaugural essay 
"Upon the influence of the passions in the production and cure of 
diseases," which was printed, in compliance with a rule of the Uni- 
versity existing at the time. This essay exhibits the practical turn 
of his mind even at that early period, consisting chiefly of a collec- 
tion of facts, gathered from various sources with no little industry. 
After his graduation, he spent a short time in the recreation of 
travel, and upon his return, about the close of summer or begin- 
ning of autumn, entered upon the duties of his profession, as resi- 
dent physician in the Yellow Fever Hospital. It was under a most 
solemn sense of his responsibility that he thus commenced his pro- 
fessional career. He felt habitually that he was in the immediate 
presence of his Maker ; and from his private notes it appears that, 
conscious of his own weakness, he constantly sought for aid from 



A MEMOIR OF DR. JOSEPH PARRISH. 395 

that gracious power, whose will he endeavoured to make the rule 
of his life, and before whose judgment-seat, in his own breast, he 
strove to bring up every proposed act for approval or rejection 
With such feelings, it is superfluous to say that he distinguished 
himself in the hospital by a devoted attention to the duties of his 
station ; and his native benevolence co-operated with his sense of 
right, in leading him to apply every alleviation in his power to the 
miseries by which he was surrounded. 

The favourable impression, made by his services in this situation, 
was afterwards increased by the publication of some experiments in 
relation to the poplar worm, which were of great effect in allaying 
a very singular panic, at that time prevalent throughout the coun- 
try. An individual was found dead in his bed, and a living worm 
along with him, of that kind which frequents the Lombardy poplar, 
and is thence commonly called poplar worm. The public some- 
what unphilosophically leaped to the conclusion that the worm and 
the sudden death were in the relation of cause and effect. Rumour 
speedily collected numerous confirmatory observations; in the hot- 
bed of popular fear suspicions quickly ripened into facts ; and the 
belief came to be very widely diffused that this species of worm was 
exceedingly venomous, and that a frightful death was lurking in 
every Lombardy poplar in the country. A war of extermination 
commenced both against tfie worm and the tree which sheltered it. 
The one was slaughtered without mercy, the other given every- 
where to the axe and the flames ; and our streets would soon have 
been left without shade, but for the timely publication of the ex- 
periments alluded to, which conclusively proved that the worms 
were harmless, and the Lombardy poplar as guiltless of any nox- 
ious influence as it was of any extraordinary beauty. 

But the event which, in the early career of our late friend, con- 
tributed most to make him favourably known to the public, was 
the delivery of a course of popular lectures on chemistry, which he 
first gave in the winter of 180T-8, and repeated twice afterwards 



396 A MEMOIR OF DR. JOSEPH PARRISH. 

in successive years. Popular lectures ou scientific subjects were 
then a novelty in Philadelphia. Their annunciation was much 
more calculated to attract attention, and a successful essay was 
much more striking and permanently influential than they would 
be at the present day, when the public has become accustomed to 
such claims upon its attention, and one impression is so rapidly 
followed by another, that a lasting effect is seldom produced. Dr. 
Parrish knew how to mingle the agreeable most happily with the 
useful, and his aim was always as much as possible to unite the 
two. To be merely amusing was contrary both to his principles 
and his taste ; but no one was better aware of the necessity of 
throwing about dry details the embellishments of happy illustra- 
tion and a pleasing delivery ; and, however strict in his religious 
opinions, he would have as little thought of denying to his subject 
whatever interest of this kind he could impart to it, as of strip- 
ping a vernal landscape of its leaves and flowers, or a summer 
shower of its rainbow. He endeavoured to give to his instruc- 
tions a practical bearing upon the ordinary pursuits of life, mingled 
with the chemical details various physiological observations calcu- 
lated to obviate the too natural tendency of the uninstructed to 
empiricism, and took advantage of the numerous opportunities, 
offered by his subject, to illustrate the wisdom and goodness of 
Providence, and to mingle lessons of piety with those of science. 
There is no doubt that he contributed by these lectures to awaken 
that spirit of popular instruction which has not since slumbered in 
our city ; while he earned for himself a reputation, highly advan- 
tageous in the prosecution of his professional views. 

In the mean time he had been attending diligently to practice, 
and was acquiring, in the arduous labours of the Philadelphia Dis- 
pensary, that experience of disease which was necessary to confi- 
dence in himself, and to inspire confidence into those who might 
from other causes be disposed to favour him. He was chosen one 
of the physicians of the institution in 1806, and continued to serve 



A MEMOIR OF DR. JOSEPH PARRISH. 39T 

it zealously until the increase of his private business compelled 
him to withdraw. Upon his resignation in 1812, he received the 
thanks of the managers "for the faithful discharge of the duties 
of his office for six years and a half." In 1818, he was himself 
elected a manager, and in 1835 was appointed one of the consult- 
ing physicians of the institution ; and the latter station was re- 
tained by him to the time of his death. 

In October, 1808, about three years after he had commenced 
practice, having been so far successful as to feel justified in incur- 
ring the additional expenses of a family, he married a young lady 
from Burlington, the daughter of John Cox, one of the most re- 
spectable citizens of New Jersey, and then as at present a highly 
esteemed preacher in the Society of Friends. This connection 
was in every way happy for Dr. Parrish. It threw an almost un- 
interrupted sunshine over the course of his domestic life, and sur- 
rounded him at its close with the consoling sympathies of a large 
and most affectionate family, whose love and reverence he had 
earned by a cordial participation in their feelings, and an ever- 
active yet well- regulated interest in their welfare. His wife sur- 
vived him, and he never had to mourn the loss of a child. Few 
men have been more exempt from the miseries which but too fre- 
quently invade the domestic circle, and few have better deserved 
such exemption. 

There has, perhaps, been no example in Philadelphia of more 
rapid professional success than that which fell to the lot of Dr. 
Parrish. Yarious causes contributed to this result. Among them 
may be mentioned his fellowship with the Society of Friends, 
always favourably disposed towards their own members, and at 
that time capable of extending an effective patronage, as there 
were few physicians among them; and the countenance of Dr. 
Wistar, who, on frequent occasions, exhibited confidence in the 
skill of his former pupil, and took every opportunity of promoting 
his professional interests. But it was undoubtedly to his own 



398 A MEMOIR OF DR. JOSEPH PARRISH. 

qualifications and efforts that he was chiefly indebted. I shall 
have occasion, in the subsequent part of this memoir, to speak of 
those peculiarities of manner and of character by which he was so 
favourably distinguished, and which were so happily in harmony 
with his pursuit. They were powerfully instrumental to his suc- 
cess by inclining opinion favourably towards him, and thus giving 
full scope to the influence of his professional excellencies, which 
might have escaped attention if wrapped in the garb of a repul- 
sive manner, or have been neutralized in their effect if mingled 
with vicious propensities or opinions. 

I have before noticed certain events in his life which had the 
effect of bringing him advantageously before the public. He had 
already acquired a large practice, and was growing rapidly in 
reputation, when, in the winter of 1812-13, the great typhous epi- 
demic, which so long scourged this country, made its appearance 
in Philadelphia, and elevated him at once into the foremost rank 
of his profession. At its first appearance, this complaint was not 
fully understood. Physicians were not generally prepared to re- 
cognize a disease of debility, associated with apparently violent 
inflammation, and were in the beginning too apt to overlook the 
tendency to prostration, which lurked fatally beneath the show of 
excitement. The attention of Dr. Parrish had been strongly 
directed to the subject by the perusal of a treatise by Dr. North, 
who had seen much of the disease in New England, and who 
strenuously advocated the stimulant treatment. His aversion to 
theory in medicine left him open to the evidence of facts, however 
opposed to prevailing opinions; and he was quite prepared to 
encounter the disease by methods which had stood the test of ex- 
perience, rather than by those which analogy alone would appear 
to indicate. The epidemic approached Philadelphia through New 
Jersey, and hung for awhile over the opposite shore of the Dela- 
ware, before it burst upon our city. The inhabitants were alarmed 
by reports of a terrible disease in the town of Camden, which 



A MEMOIR OF DR. JOSEPH PARRISH. 399 

appeared to bid defiance to medicine. Dr. Parrish was called in 
to the aid of the physicians of the neighbourhood. At the period 
of his first visit, seven cases had occurred and all proved fatal. 
He was told that the disease was of an inflammatory nature, and 
had been treated by the lancet and other depletory measures. Its 
malignant aspect at once struck his attention. He saw through 
the veil of inflammation which it had thrown over its ghastly fea- 
tures, and beheld the deadly weakness beneath it. He advised 
an immediate abandonment of the lancet, and the substitution of 
an actively stimulant treatment. The effects were most happy. 
Numbers now got well where before all had died. A disease sup- 
posed to be almost incurable was found to be, in the great majority 
of cases, under the control of medicine. The terrors of the first 
awful reports gave way before the happier intelligence which fol- 
lowed ; and the newly inspired confidence was directed especially 
towards the author of the change. When the epidemic reached 
the city, Dr. Parrish found himself in the midst of an ample busi- 
ness ; and the devotion which he paid to the sick, and the skill 
and success which marked his efforts, gave him a place in the 
opinions and affections of his fellow-citizens which he did not lose 
when the immediate occasion ceased. His views of the disease 
and its treatment met with much opposition ; and some decision 
of character was required to carry them into effect. On one occa- 
sion, a physician in attendance with him upon two cases of the 
disease in the same family, believing them to be highly inflamma- 
tory, strongly urged the employment of the lancet, and, upon being 
resisted by Dr. Parrish, who felt convinced that the proposed 
remedy would be fatal, retired from attendance, leaving the whole 
responsibility with his colleague. The ground of difference was 
known, and the eyes of the whole neighbourhood were directed 
with intense expectation towards the result. "You cannot con- 
ceive," said Dr. Parrish in relating the circumstance to his pupils, 



400 A MEMOIR OF DR. JOSEPH PARRISH. 

"the anxiety I experienced." Happily, however, both patients 
recovered, and the event contributed to extend his reputation. 

But his attention was not restricted to the practice of medicine 
exclusively. From the commencement of his professional life he 
had exhibited an inclination towards surgery, which he cultivated 
assiduously whenever opportunities were offered. Towards the 
close of the year 1806, he was elected surgeon to the Philadelphia 
Alms House, where he had an ample field for observation and ex- 
perience, especially in that branch of the surgical art, always high- 
est in his esteem, which aims at repairing injuries by a judicious 
employment of the resources of the system, and, so far from seeking 
occasion for painful or deforming operations, endeavours to render 
them unnecessary. His reputation as a surgeon was of slower 
growth, but scarcely less distinguished in the end than that which 
belonged to him as a medical practitioner. His skill in diagnosis 
and judgment in the choice of therapeutic measures were highly 
appreciated by his medical brethren, by whom he was constantly 
called into consultation, not only in Philadelphia, but also in the 
country for many miles around it. As an operator also he took 
rank with the most prominent surgeons of the city, and, at the 
period of life when his physical powers were at their height, was 
second only to Dr. Physick, either in the number and magnitude 
of the operations which he performed, or in the extent of his repu- 
tation. 

In addition to his station in the Alms House Infirmary, he was 
in the year 1816 elected surgeon to the Pennsylvania Hospital as 
successor to Dr. Physick, and continued to discharge the duties of 
the two offices conjointly for about six years. His place in the 
Pennsylvania Hospital he retained till 1829, when the state of his 
health, which was at that time feeble, and a disposition to relin- 
quish the more fatiguing and severer offices of surgery to younger 
hands, induced him to withdraw entirely from professional connec- 
tion with the public institutions. He considered the decline of 



A MEMOIR OF DR. JOSEPH PARRISH. 401 

bodily strength in a surgeon as an intimation from nature that the 
period for active service was passed ; and I have often heard him 
say, that the necessity of using spectacles was regarded by him as 
a call of duty to shun operations, in which a jet of blood from a 
divided artery might occasion temporary blindness. 

During the whole course of his service in the public hospitals, 
he was assiduous in the discharge of his duties, not considering 
the situation as one of mere personal advantage, but as involving 
higher obligations, and among these a watchful care over the inter- 
ests of the institution, and a strict attention to the comforts as well 
as the health of the inmates. I have never heard the breath of 
accusation against him in relation to the discharge of this high 
trust. It was in the Alms House Infirmary that he first attracted 
notice by his clinical lectures, and laid the foundation of that repu- 
tation, as a medical teacher, with which all who now hear me are 
familiar. In his regular rounds among the patients, both in this 
institution and the Pennsylvania Hospital, he seldom omitted an 
opportunity of giving useful practical lessons to the students who 
attended him ; and, so attractive was his manner, so impressive his 
instructions, and so obvious the high motives by which he was ac- 
tuated, that large numbers constantly followed him, who afterwards 
carried home with them, into almost all parts of the Union, a great 
and affectionate respect for his virtues, talents, and attainments. 

A natural consequence of his growing reputation as a prac- 
titioner and clinical lecturer was a great increase of private pupils. 
He was seldom without one or more students, even from the com- 
mencement of his practice; but it was not till the year 1814, or 
1815, that their number became considerable. From this period 
they rapidly increased, till they amounted at length to about thirty; 
a number at that time quite unprecedented, in this country, among 
physicians not immediately connected with the great medical 
schools, and equalled, I believe, only in one instance where this 

26 



402 A MEMOIR OF DR. JOSEPH PARRISH. 

advantage was possessed by the teacher. Young men came to 
study with him from various parts of the Union ; but the greater 
number were of Philadelphia and its immediate neighbourhood; 
and, as this was the place where he was best known, and no ex- 
traneous motives influenced the choice of the pupils, the fact 
speaks strongly in favour not only of his reputation, but also of 
his real merits. Among the present practitioners of this city, 
there are, I presume, more of his former pupils, than of those edu- 
cated by any other physician. He was in the habit of lecturing to 
the young gentlemen in his office twice a week, during almost the 
whole year; in the winter upon surgery, and in the summer on the 
practice of medicine; giving in his lectures not so much that ele- 
mentary knowledge which is to be derived from books, as the result 
of his own experience and reflection. 

About the year 1818, he was induced by the great increase of 
his pupils, and by his own almost oppressive engagements, to pro- 
cure assistance in the instruction of his class, especially in those 
elementary branches of medicine which, though apt in their minu- 
tiae to escape the recollection of practitioners, are nevertheless 
indispensable to the student as the basis of all professional knowl- 
edge. The extent of this aid was gradually increased, till at length 
courses of lectures were delivered every year upon chemistry, ana- 
tomy, and materia medica, to which midwifery was afterwards 
added ; as he himself never cultivated this branch of our art, and 
did not feel himself competent to teach it. Besides lectures, a 
regular series of minute examinations upon all the different branches 
was also instituted; so that a complete system of private instruc- 
tion sprang up under his hands, which, if not antecedent to others 
of a similar character, was certainly original with himself and those 
who assisted him. Dr. Parrish, therefore, may be looked upon as 
one of the founders of that combined and more thorough scheme of 
private medical tuition, which constitutes a distinguishing profes- 
sional feature of our city and our times; and, upon this ground 



A MEMOIR OF DR. JOSEPH PARRISH. 403 

alone, would have claims to a most favourable place in our recol- 
lections.* 

He sustained this system of medical instruction, with a number 
of pupils, varying from about ten to thirty, till the year 1830, when 
he yielded to the influence of an institution conducted upon a plan 
somewhat similar to his own, but combining the talent and profes- 
sional weight of some of the most prominent physicians of this 
city, of whom, moreover, several had the advantage of being con- 
nected with the most flourishing medical school in the country. 

But his peculiar abilities as a lecturer were not yet lost to the 
medical community. An association of physicians was formed, 
called the "Philadelphia Association for Medical Instruction," at 
the head of which he allowed his name to be placed, and in which 
he continued to labour faithfully as long as it existed. The object 
of this association, as many of you well know, was not to compete 
with the public schools, but merely to afford to the private pupils 
of the members those advantages which were enjoyed by others, 
and which it was not in the power of any one individual to bestow. 
It continued in successful operation for about six years, when it 
was dissolved in consequence chiefly of the advancing age of its 
main supporter, who began to feel that he had borne his share in 
the burdens of the day, and was justified in withdrawing from a 
portion at least of those labours, which, though they had not sur- 
passed his energies or will in the prime of his life, began now to 
press heavily upon him. 

* I have learned, since delivering the address, that the priority in the 
establishment of the combined system of private medical insti'uction alluded 
to in the text, belongs to Dr. Chapman, of the University of Pennsylvania. 
He associated Dr. Horner with him in the instruction of his private pupils 
in the year 1817; while the first step was not taken by Dr. Parrish till 1818, 
when he engaged my assistance. The statements, however, in the address 
are, I believe, literally correct; for, to the best of my knowledge, Dr. Parrish, 
at the time he commenced, was not aware that a similar arrangement had 
been made by any other individual. [Note to the address when first published.) 



404 A MEMOIR OF DR. JOSEPH PARRISH. 

Let us here pause, for a few minutes, to consider his position at 
that period when his mental and corporeal powers were in their 
greatest vigour, his reputation at its height, and all his faculties in 
the fullest exercise. Few individuals have held in this city a more 
enviable station. His professional business equalled his highest 
wishes both in character and amount, lying chiefly among the most 
respectable inhabitants, aud being scarcely short of his utmost phy- 
sical capabilities. He was in the frequent receipt of letters from 
various parts of the Union, requesting professional advice ; per- 
sons often came from great distances on purpose to consult him in 
obscure and difficult cases; and such was his reputation out of the 
city, that his aid in consultation was habitually sought by numerous 
physicians in all directions around Philadelphia, and not unfre- 
quently at such distances as to render compliance impossible. With 
his medical brethren at home he was upon the most friendly foot- 
ing, enjoying in a remarkable degree their respect and confidence, 
and constantly consulted by them when additional aid was required. 
When we recollect that, to this great mass of private business, there 
were added a regular attendance as surgeon in our two great public 
hospitals, and the delivery of two courses of lectures in each year 
to his private pupils, we shall be prepared to understand that his 
time was fully occupied in active duties, and that little opportunity 
was afforded him for relaxation, or social enjoyment. 

But, though occasionally oppressed with the weight of these va- 
rious cares, he experienced that high gratification which always 
springs from the full exercise of our powers, when accompanied 
with the consciousness that they are properly directed, and often 
observed to his friends that he had never, on occasion of the severest 
trials, even for a moment, repented that he had devoted himself to 
the profession of medicine. He was cheered, moreover, by the affec- 
tionate kindness which everywhere met him, and which was but a 
just return for that general benevolence with which his own breast 
overflowed. Almost universally known, he never appeared in the 



A MEMOIR OF DR. JOSEPH PARRISH. 405 

streets without meeting the grateful and cordial greeting of per- 
sons indebted to him for life, or health, or some other blessing; 
and in every sick chamber which he visited, his own bright smile 
was reflected from every countenance not overwhelmed with anxiety 
or grief. Affection beamed cheerfully upon his daily round ; and 
the kindnesses which he scattered like flowers along his path, re- 
turned in delicious fragrance to his own gratified sense. He 
enjoyed exceedingly those intervals of business in which he could 
unbend himself in the company of his family and friends ; and the 
sweetness of his temper, the cheerfulness and naivete of his manner, 
his fund of pleasing anecdote, and the goodness of heart which 
shone forth in all that he said and did, rendered him, on such occa- 
sions, the source of even greater gratification than he received. 
The social circle which habitually met at his house was, indeed, a 
happy one ; and they who have mingled in it will often recall its 
calm and innocent, yet vivid enjoyments, with a sigh that they are 
passed, and cannot retu/n. 

Though occupied as^we have seen, Dr. Parrish found time to 
contribute various medical and surgical papers to the journals, all 
of which are characteristic of his practical turn of mind, and some 
highly valuable. They are contained chiefly in the Eclectic Reper- 
tory, of which he was one of the editors, and in the North Ameri- 
can Medical and Surgical Journal. Among them may be men- 
tioned, as worthy of especial attention, "Observations on a peculiar 
catarrhal complaint in children, 1 ' 1 "On infantile convulsions aris- 
ing from intestinal spasm" "On affections of the mammae liable 
to be mistaken for cancer," "On pulmonary consumption 11 and 
"On the connection between external scrofula and pulmonary 
consumption.'' 1 His remarks on the last-mentioned disease are 
highly interesting, not only from their intrinsic value, but also from 
the fact, that his views in relation to its treatment were justified by 
the result in his own case. Attacked, when a young man, by a 
complaint of the chest which he believed to be of a consumptive 



40 G A MEMOIR OF DR. JOSEPH PARRISH. 

character, instead of confining himself to his chamber, and going 
through a long course of medicine, as was then fatally common, he 
adopted the plan, which he always recommended to his patients, of 
vigorous exercise in the open air. Most of you recollect the un- 
pretending vehicle, in which he was accustomed to pay his daily 
professional visits. It was without springs, and its jolting move- 
ment over our rough pavements was anything but comfortable to 
its occupants. This, however, was its recommendation with the 
Doctor, who thus imitated, as nearly as possible, the effects of 
horseback exercise, and combined the pursuit of health with that 
of business. It is scarcely necessary for me to say that he entirely 
recovered from his pectoral affection. After his death, dissection 
revealed tuberculous cicatrices in the upper portion of each lung, 
and thus proved both the correctness of his diagnosis, and the effi- 
cacy of his plan of treatment. Were time allowed me, I might 
here expatiate with advantage upon his opinions and practice in 
consumption, and in various other complaints ; but this office must 
be deferred to another opportunity, if not to another hand. It will 
at present be sufficient to state, in addition, that he republished 
Lawrence on Hernia, with an Appendix, and, a few years before his 
death, put forth a work of his own upon Hernia and Diseases of 
the Urinary Organs. 

In the midst of his private engagements, he participated largely 
in the proceedings of those medical associations whose constitution 
and objects he could cordially approve. He was long an active 
member of the College of Physicians, in which he held successively 
the offices of secretary, censor, and vice-president, and in all whose 
transactions he took a lively interest. Of the Society, moreover, 
which I have the honour to address, he was a zealous member, 
and, at the time of life in which we are now considering him, was 
one of the most efficient speakers. They who are old enough to 
remember the highly animating scenes, which took place in the 
Medical Society about twenty years since, cannot have forgotten 



A MEMOIR OF DR. JOSEPH PARRISH. 407 

the prominent share in the debates taken by Dr. Parrish, nor the 
life and vigour, yet perfect good nature and amiableness, which 
characterized his style of speaking. His undaunted opposition to 
the assaults, which the theory of Broussais was then making upon 
the old medical opinions, was fruitful in interest and results. It 
was on one of these occasions that he brought before the Society 
the stomachs of recently slaughtered animals, to show that those 
post-mortem appearances which had been considered as proofs of 
pre-existing inflammation, were often present in cases of violent 
death, occurring in perfect health. He was for some time vice- 
president of the Medical Society. That he did not hold a higher 
station was owing to an invincible repugnance, on his own part, 
to stand in the way of what might be considered the just or reason- 
able claims of others ; and not only here but in all other places, he 
would accept of no office, the access to which must be over the 
disappointed hopes, or wounded feelings of a medical brother. 

But his sympathies were not confined within the limits of his 
profession. He took a lively interest in the concerns of the com- 
munity in which he lived, and, whenever opportunity appeared to 
offer for useful interposition, was not slow in contributing his share 
either of advice, of personal service, or of money. He occasionally 
sent anonymous communications to the daily papers, in relation to 
objects which he deemed it important to press upon the public 
attention, especially such as seemed to fall peculiarly within the 
province of the physician. Among these communications may be 
mentioned a series of essays published in the Village Record of 
West Chester, in this State, in which he endeavoured to point out 
to the country people the various sources of miasmata existing in 
the decaying vegetation around them, as well as the best means of 
preventing the production of these effluvia, and of obviating their 
effects. 

A strenuous advocate, on all occasions, for the rights of his 
fellow-men, he suffered no motives of present convenience to pre- 



408 A MEMOIR OF DR. JOSEPH PARRISH. 

vent him from interfering by word and deed whenever he believed 
these rights to be invaded. The wrongs of the poor Indian were 
not unfrequently the subject of his pen ; and his sympathy for the 
degraded negro was ever active, though preserved by his sound 
judgment within the bounds of propriety. Like all the members 
of his sect, au uncompromising opponent of slavery, he never hesi- 
tated to express his sentiments upon the subject, nor to yield his 
aid and counsel in individual cases. He was long a member, and 
ultimately president of the old Pennsylvania Abolition Society, in 
which office he had been preceded by Drs. Wistar, Rush, and 
Franklin ; was one of a committee deputed by the yearly meeting 
of his religious associates, to lay their views and hopes in regard 
to slavery before Congress; and was selected by the eccentric 
John Randolph, when on his death-bed in Philadelphia, to be a 
witness of his last wishes in relation to his slaves, and, as a neces- 
sary consequence, to be the organ of these wishes before the courts 
of Virginia. For the due performance of the offices thus imposed 
upon him, he was peculiarly qualified ; as, with the firmness which 
enabled him to adhere unswervingly to what he believed to be 
truth and justice, he combined a suavity of manner, a benevolence 
of feeling, an openness of character, and an obvious singleness of 
purpose, which disarmed hostility, and disposed even those who 
were most averse to his views, to admire and love him as a man. 

The same benevolence which impelled him to the relief of the 
helpless and oppressed, caused him to incline to leniency in pun- 
ishment; and, ever ready to forgive an injury to himself indi- 
vidually, he was prone also to forgiveness in his social capacity, at 
least was accustomed, in doubtful cases, to lean strongly to the 
side of mercy. He shared fully in that aversion to the taking of 
human life which is almost universal among the Friends, and car- 
ried on a newspaper controversy with a learned divine upon the 
subject of capital punishments, in which he endeavoured to show, 
by reference to the original Hebrew, that the Scriptural authority 



A MEMOIR OF DR. JOSEPH PARRISH. 409 

claimed for them was without foundation, while he maintained 
their inexpediency, and their contradiction to the whole tenor of 
Christian morals. In the cases of individuals on trial for crimes, 
or already convicted, he was disposed to give the most favour- 
able interpretation to every equivocal point, and experienced the 
highest satisfaction when able, in his medical capacity, to screen 
suspected innocence, or conscientiously to interpose between a sen- 
tence of doubtful justice and its execution. In the instance of the 
maniac Zimmerman, who was confined at Orwigsburg under sen- 
tence of death for killing his daughter, he was one of a committee 
of the College of Physicians, appointed at his own motion, to visit 
and examine the prisoner; and was thus instrumental in saving a 
fellow-being from unmerited punishment, and the authorities from 
the guilt of a judicial murder.* 

* The following anecdote is so strikingly illustrative of Dr. Parrish's 
mode of thinking and acting in criminal cases, that I cannot deny my- 
self the satisfaction of inserting it here in the form of a note. A family 
consisting of numerous persons became suddenly ill, after partaking of a 
meal, and exhibited all the characteristic marks of poison. One of the 
family died, and dissection confirmed the evidence of the symptoms. Sus- 
picion fell upon a female servant, whose character, upon investigation, did 
not turn out to be in her favour. Though no proof of her guilt existed, a 
strong disposition was evinced to implicate her in the crime. Such was the 
hostile feeling excited towards her, that the coroner's inquest, which sat 
upon the case, needed but the slightest countenance from the physicians to 
bring in a verdict against her. Dr. Parrish believed it to be his duty to 
shield her from any possible injustice. He, and another medical gentle- 
man who was in attendance, testified that both the woman and a child of 
hers were affected in the same manner with the rest of the family. It was 
urged in reply that she had feigned sickness, and had deceived the physi- 
cians. It suddenly occurred to Dr. Parrish that, in all the cases which he 
had examined, there was a white furred tongue. He stated this fact to the 
jury, and proposed that they should examine the tongues of all who had 
been affected. This was assented to, and a display of tongues was accord- 



410 A MEMOIR OF DR. JOSEPH PARRISH. 

Nor was his attention restricted exclusively to secular affairs. A 
zealous member of the church to which he belonged, and in which, 
towards the close of his life, he accepted the office of elder, he par- 
ticipated in all its business, entered with spirit into its controver- 
sies, and wrote much in relation to its interests and its tenets. It 
is well known, I presume, to all who hear me, that not many years 
since a division occurred in the Society of Friends, and that Dr. 
Parrish took a decided part with that section of the society to 
which he attached himself. Yet, amid all the difficulties of the 
separation, when excitement too often counselled violent measures, 
he was uniformly the advocate of peace, and, in his writings, sedu- 
lously avoided that strain of bitterness which is so apt to infuse 
itself into theological controversies, and to leaven all truly reli- 
gious feeling into its own evil nature. It was a source of comfort 
to him, that most of his nearest relatives and friends were of the 
same mode of thinking with himself; and that even with such of 
them as could not coincide with him in sentiment, he yet succeeded 
in maintaining an uninterrupted harmony of feeling, springing out 
of a just mutual appreciation of character and worth. 

Such as I have endeavoured to represent them were the va- 
rious engagements which crowded the time of Dr. Parrish, at the 
period of his greatest activity. As he advanced in years, the 
burden which had sat lightly upon his vigorous manhood became 
oppressive ; and, as he was in possession of a fortune amply com- 
petent to his wants, he began gradually to withdraw from the 
more onerous duties of his profession, and to confine his atten- 

ingly made. It was found that those of the woman and her child were at 
least as heavily furred as any of the others. The jury was satisfied, and 
refused to implicate her in their verdict. This, however, did not satisfy 
the family. Such a statement was made before a magistrate, that the poor 
woman was arrested and thrown into prison, where she remained several 
months awaiting her trial. Upon being brought before the grand jury, she 
was discharged, for want of testimony, on a verdict of ignoramus. (Note to 
the address when first published. ) 



A MEMOIR OF DR. JOSEPH PARRISH. 411 

tion chiefly to cases, in which there was less demand for active ex- 
ertion than for the judgment and skill resulting from experience. 
He could not, however, without doing too great violence to his 
feelings, abruptly break off from attendance upon those who had 
long intrusted their lives to his care. I have more than once 
heard him quote, as in some measure applicable to himself, a com- 
plaint made by Dr. Wistar, when desirous of declining business, 
yet unable to resist the solicitations of his old patients, that what 
had in early life constituted his highest hope, was now become his 
greatest source of discomfort. He succeeded, however, in gradu- 
ally transferring the most laborious part of his business to younger 
and more willing shoulders. He first resigned his station in the 
hospitals, then withdrew by degrees from operative surgery, and 
finally limited his professional occupation to attendance upon 
families who had long employed him, to the performance of a few 
favourite surgical operations, such as those for cataract, strangu- 
lated hernia, and diseases of the urinary passages, and to consulta- 
tions with his brother practitioners, which were always grateful 
to him, and continued to be numerous up to the time of his last 
illness. 

There was a short period after he had begun to contract his 
business, during which he again put forth all his energies, and 
laboured with the spirit and activity of youth. This was during 
the prevalence of the epidemic cholera in Philadelphia. At the 
approach of this disease, he felt like the veteran warrior, who, 
while resting upon his laurels, hears the distant sounds of invasion, 
and rushes once more eagerly to the contest. He was one of the 
most efficient members of the Sanitary Committee, took an active 
share in the organization of the hospitals, and exerted his influ- 
ence effectively in calming the fears, and overcoming the prejudices 
of the citizens, which threatened materially to interfere with the 
requisite arrangements. He had himself the special charge of an 
hospital, in which he spent much time in a close observation of 



412 A MEMOIR OF DR. JOSEPH PARRISH. 

the disease, in prescribing and even administering to the sick, and 
in providing in every possible way for their comfort as well as res- 
toration to health. Believing that a cheerful and confident state 
of mind contributed much to recovery, he endeavoured to remove 
from around the patients, as far as circumstances would permit, 
everything of a depressing or alarming character, and among other 
means of producing a pleasing effect, procured a number of beau- 
tiful plants, which he distributed about the entrance of the hospi- 
tal, and in the open grounds in the rear. He was at the same 
time largely engaged with private patients and in consultations ; 
and answered numerous letters addressed to him by his former 
pupils and other practitioners seeking for advice, so that his 
opinions were widely diffused, and gave a tone to the practice in 
many places. But when the danger was over, and the health of 
the city, purified by the late storm, became sounder even than in 
former years, he felt himself justified in returning to his previous 
purpose. 

His life, however, was at no time a life of idleness. Few things 
were more abhorrent to his nature than mental inactivity ; and, in 
his last illness, he considered as among his greatest trials that de- 
bility of mind which he felt to be stealing over him, a few days 
before his close. Even in the intervals of business, his intellect 
was ever active. He has often told me, that many of his peculiar 
views, both general and professional, were the result of reflection 
during his solitary rides from house to house in pursuit of his busi- 
ness. His last years, therefore, though less cumbered by almost 
overwhelming engagements than those of his earlier life, were still 
fully and profitably occupied. Besides attending to his restricted 
practice, to his duties as the father of a large family and a promi- 
nent member of his church, and to the care of a not inconsiderable 
estate, he participated also in various public concerns of a useful 
or charitable character. He was especially active in the organiza- 
tion and subsequent management of the Wills' Hospital for the 



A MEMOIR OF DR. JOSEPH PARRISH. 413 

lame and blind ; and was president of the board of managers in 
this institution from its commencement to the' time of his death. 
One of his prominent enjoyments, in his declining years, was the 
superintendence of arrangements for the setting out in life of his 
adult children, in whose hopes and efforts he largely participated, 
and in whom he used to observe that he was living over again his 
own younger days. 

Having now followed the current of his life till near its termina- 
tion, let us endeavour to sketch his peculiar mental lineaments, and 
form a portrait of his character, while still fresh in our memory. 

Of the moral attributes of Dr. Parrish, which he derived from 
nature, the two most prominent were, probably, love for his fellow- 
'men, and a desire to stand well in their opinions. His preceptor, 
Dr. Wistar, who loved and esteemed him highly, used to say, that 
he had the ambition of Bonaparte and the benevolence of Howard. 
In the best sense of the word, he was undoubtedly ambitious. It 
is trne that he never sought for power, and was altogether indif- 
ferent to the distinction of office, unless in so far as it evinced the 
good opinion of those by whom the office was conferred. But no 
man was more desirous than he to stand high in the esteem of 
others, and none felt more keenly marks of respect and affection 
on the one hand, or of disrespect and ill-will on the other. Of this 
trait in his character he was himself fully aware ; and we find him 
in early life, when under strong religious impressions, struggling in 
secret against its tendencies. Among his private notes is the fol- 
lowing reference to himself, at a time when he was endeavouring 
to bring himself more completely under the influence of that in- 
ward light, in the supernatural origin of which he believed as 
firmly as in his own existence. " Thou hast certainly been at times 
divinely illuminated; but alas! the cares of this world, not its 
riches so much as its honours, how does a desire after them eclipse 
the Heavenly luminary!" He was never unwilling to admit the 
existence of this love of distinction. It constituted, indeed, one 



414 A MEMOIR OF DR. JOSEPH PARRISH. 

of his most powerful impulses to action ; and in his case, as it will 
prove to be in that of every other person who may possess, and be 
able to regulate it, was a principle of usefulness both to himself 
and others. If, under any circumstances, it exceeded the proper 
bounds in the case of Dr. Parrish, it was by the pain which it occa- 
sioned him when he met with unkind or unjust treatment, or was 
at any time made the subject of injurious report. He could not, 
perhaps, sufficiently, and he certainly never pretended to despise 
unmerited censure. But, though he suffered from this cause, he 
never allowed it to influence his actions, and few have ever been 
more ready to forgive an injury, or to return good for evil. 

But benevolence was a still more striking trait in his character. 
His good-will to all around him was observable in almost every 
movement. Towards those in suffering it was peculiarly conspicu- 
ous. Hence the charm of his deportment in the sick chamber. 
Nothing could surpass the beautiful kindness of his manner to- 
wards the sick poor whom he attended. He spoke to them in the 
most friendly tones, soothed their anxieties, respected their inno- 
cent prejudices, and, in his rounds in the hospitals, uniformly had 
regard to their feelings, avoiding, in his clinical remarks, whatever 
could wound their sensibility, or excite needless alarm. They who 
have walked the hospitals with him must recollect how the coun- 
tenances of the patients were lighted up at his approach, as if they 
viewed in him not only their physician but their friend. He used 
to relate frequent instances of their grateful remembrance of his 
kindness, and never joined in that very common complaint of the 
ingratitude of the poor for medical services ; an ingratitude often 
resulting from a coldness or harshness of manner on the part of 
the physician, which leaves the impression that the service was 
performed merely as a matter of duty, and could claim only a cor- 
responding reward. The practice of operative surgery occasioned 
him often great distress, especially in children, upon whom he never 
inflicted pain without appearing to suffer it in his own person; and 



A MEMOIR OF DR. JOSEPH PARRISH. 415 

operations in infantile cases became at length so distasteful to him, 
that he avoided them whenever he could do so with propriety. 

Nor was the benevolence of Dr. Parrish merely of a passive char- 
acter. It was, on the contrary, highly practical. Not only was he 
liberal with his purse on every suitable occasion, which is the easiest 
mode of charity to one who possesses the means, but contributed 
freely also his time and service, both professionally and otherwise. 
No physician in Philadelphia, I presume, has attended more patients 
gratuitously than Dr. Parrish. He was peculiarly cautious not to 
burden the slender means of those who, from comfortable or affluent 
circumstances, had been brought into comparative poverty, and 
were struggling, on reduced incomes, to sustain a decent appear- 
ance in the world. When he had reason to suspect that any of his 
patients were in this condition, he would often endeavour to satisfy 
himself of the truth by the most delicate means in his power, and 
would then contrive, in the manner least offensive to their feelings, 
to avoid receiving compensation for his services, without leaving 
behind an oppressive sense of obligation. He never, on any occa- 
sion, exacted payment of a medical fee; and so strong was his 
aversion to compulsory modes of collecting debts of this nature, 
that in his will he expressly and strictly enjoined on his executors 
to put no claim on account of medical services into legal suit. He 
made it a point not to charge for attendance in cases of injury 
received by firemen in the discharge of their duty. For at least 
twenty years, he was in the daily habit of receiving patients at a 
certain hour ; and, as he was well known never to refuse advice, 
and never to charge those who could not afford to pay him, crowds 
flocked to his house, which, on such occasions, often resembled a 
public dispensary rather than a private dwelling.* 

* The following anecdote, which was told me by an eye-witness, proves 
that his benevolence of character, though it may have been improved by 
cultivation, was innate. The event occurred, if I remember rightly, when 



41 G A MEMOIR OF DR. JOSEPH PARRISH. 

His conscientiousness was not inferior to his benevolence, and 
tlie two often co-operated to the same end. Hence it was that 
cruelty, oppression, and every form of injustice were so abhorrent 
to his nature. Almost the only occasions upon which I have seen 
him really indignant, were those in which he conceived the rights 
of the weak to be invaded by the strong, or injuries inflicted where 
there was no power of resistance or redress. Perhaps his sensi- 
tiveness on this point, may sometimes have led him into misappre- 
hension of the motives of others, and a little temporary injustice of 
opinion ; but this was a very slight and scarcely sensible counter- 
poise to the amount of generous feeling which was called forth. 
The same feeling was extended towards the brute creation. The 
animals which he had occasion to use, were always treated with 
the greatest kindness ; and the provision made in his will for the 
old age of a favourite horse, which had served him long and faith- 
fully, is generally known. Old Lyon was a remarkable brute, and 
almost as well known in Philadelphia as his master. The dog-like 
docility with which he followed at the word of the Doctor, and the 
sagacity with which, when left to himself, he moved off with the 
vehicle to some shady spot in summer, or to some sheltered posi- 
tion in winter, were subjects of almost universal remark. 

In all his pecuniary transactions, Dr. Parrish was scrupulously 
just. He did not feel himself authorized to take advantage of 
another in a bargain, and never incurred any responsibility which 
he was not fully able to meet. He had insurmountable objections 
to indorsements, on the score of the temptations which their facility 

he was a boy about ten years old. Meeting a young child in the street, 
during winter, who was carrying something in his naked hands and crying 
bitterly, he put his arms about the little fellow's neck, and finding, upon 
inquiry, that he was suffering from the cold, took his aching hands in his 
own, and having warmed them, put upon them a pair of woollen gloves 
which he had with him, and sent him forward comforted on his errand. [Note 
to the address when first published.) 






A MEMOIR OP DR. JOSEPH PARRISH. 41*7 

afforded to extravagant risk, and would never lend his name in this 
way to his nearest friend or relative, preferring a direct loan of the 
money, if in his power, to the loan of his credit. 

His conscientiousness was exhibited also in various other ways. 
All those who have studied with him must vividly remember the 
catalogue of evils, incident to the study and practice of medicine, 
called by him his " black list," which he held up to the view of 
young men upon their first application to him as their preceptor, 
so that they might not enter the profession with false views and 
expectations, or at least that no blame might be imputable to him- 
self for undue encouragement, should their expectations be disap- 
pointed. 

In his medical lectures he felt himself bound, in detailing his 
experience, not to conceal his mistakes, so that the pupil might 
have the benefit not only of his successes as an example, but also 
of his mis-steps as a warning. Few are capable of this magna- 
nimity, the great majority being satisfied if they tell only the truth, 
without in all cases telling the whole truth. 

One of the most striking instances of the influence of a sense 
of duty over his conduct, was in his declining to take the office 
of professor of anatomy in the University of Pennsylvania, which 
he believed, and I have no doubt upon the best grounds, to have 
been at one time within his reach. I have said that he was natu- 
rally fond of distinction ; and this was a post to which he believed 
himself competent, and in which he would probably have attained 
much credit, and a wide-spread popularity. An ordinary person, 
in his situation, would have seized upon it with avidity. But he 
regulated his conduct by a higher standard than that of personal 
gratification. He believed that a station in the University would 
bring what might be considered his duty towards the institution 
into frequent conflict with his peculiar religious sentiments and 
habits. He was unwilling to expose himself to temptations, likely 
to loosen his hold upon those principles which he conceived to be 

27 



418 A MEMOIR OF DR. JOSEPH PARRISH. 

the anchor of his safety. To his intimate friends, who urged him 
to avail himself of this opportunity, he was wont to answer, in his 
naive and cheerful but impressive manner, by pointing to his 
breast, and observing that lie wished to have all comfortable there ; 
that no worldly advantages would be any compensation for the 
loss of that heart-felt satisfaction, which attended obedience to the 
intimations of his inward monitor. This was, indeed, the great 
rule of his life. Believing most fully in that fundamental Quaker 
doctrine that the Divine Spirit communicates directly with men, 
that from this source is the "true light which lighteth every man 
that cometh into the world," and that consequently every indi- 
vidual has a sure counsellor in his own breast, which, if consulted 
in the right spirit, will never fail or mislead him, he was in the 
constant habit of looking inward for intimations of duty, and of 
submitting to them implicitly, however opposed to his apparent 
worldly interests. Now, whatever opinion may be entertained of 
these intimations, whether we agree with the Friends in consider- 
ing them as of supernatural origin, or believe them, as most men 
do, to proceed from the natural workings of the mind, under the 
influence of education, habit, reason, and conscience, it is never- 
theless the fact that, in any case of morals, an individual, brought 
up in a civilized and Christian country, will seldom go far astray, 
who uniformly consults them with a single eye to the truth. Dr. 
Parrish believed that he found peace and safety in this rule of 
action ; and no merely worldly temptation was strong enough to 
remove him from any position which he had taken in conformity 
with it. The same motives which induced him to forego the op- 
portunity of obtaining a professorship in the University, caused 
him also to decline offers, and resist solicitations afterwards made 
to him to join other incorporated medical schools. "My bark," 
he used to say, "was made for quiet waters." 

Firmness and courage were also among the moral qualities 
which distinguished Dr. Parrish. With all his kindness of heart 



A MEMOIR OF DR. JOSEPH PAERISH. 419 

and disposition to please, though no man was less tenacious of 
opinion for opinion's sake, and none more disposed to yield in 
trifles to the convenience or even caprice of others, yet in all 
affairs which involved a point of principle he was immovable, and 
did not hesitate to do or to avow what he believed to be his duty, 
whatever personal injury or odium might accrue. 

Thus morally courageous, he was not wanting in that less noble 
attribute which leads to contempt of danger. During an intimate 
intercourse of many years, I do not remember to have seen him, in 
any one instance, exhibit the least evidence of bodily fear. In 
pestilence he was among the foremost at the post of danger. 
During the prevalence of yellow fever, I have seen him by day and 
by night, without the expectation of pecuniary recompense, and at 
a period of his professional life when he had nothing further to 
wish for on the score of reputation, enter the deserted precincts of 
infection, and expose himself to the most imminent danger, in at- 
tendance upon individuals, who had been seized by the disease 
while lingering behind the fleeing population. He delighted when 
young in the excitement and hazard of the fireman's duty, and, 
even at a comparatively late period of life, had not entirely relin- 
quished the habit of exposing his person in great conflagrations. 
I have known him, in times of public tumult, to venture into the 
midst of the excited multitude, and fearlessly oppose his personal 
influence to their mad purposes. On the bed of sickness and 
death, with a clear knowledge of his danger, he was quite com- 
posed, and never exhibited any of those fearful apprehensions 
which sometimes beset the closing scenes even of those best pre- 
pared to die. Such, indeed, was his natural temperament, that 
danger, attended with the opportunity for exertion, seemed to have 
charms for him ; and I have heard him more than once say, not in 
a boastful spirit, but quite naturally, as if merely giving expres- 
sion to the feelings of the moment, that, were he not opposed on 
principle to all wars and fightings, he should take a stern delight, 



420 A MEMOIR OF DR. JOSEPH PARRISH. 

in a cause which he could approve, in leading the forlorn hope of 
an assault. 

In relation to his intellectual faculties, Dr. Parrish was char- 
acterized by quick perception, an excellent memory for facts, and 
an unusual correctness of judgment. Little that he had the oppor- 
tunity of hearing or seeing escaped his observation, and what he 
had once stored up in his mind was ever afterwards at his com- 
mand. He had, therefore, a fund of anecdote and material for 
illustration, which rendered his conversation highly interesting as 
well as instructive, and gave him great advantages as a lecturer. 
He had little imagination, and was without the taste and perhaps 
the ability for abstract and speculative reasoning, which too often 
busies itself in constructing edifices of conclusion upon slender 
premises, and wastes in vain attempts to establish general truths 
the time which would be better spent in collecting facts. But he 
was gifted, in an extraordinary degree, with that practical faculty 
which turns to useful account whatever comes within its reach; 
which, by a sort of intuition, distinguishes a truth amidst the rub- 
bish by which it is concealed, and out of a labyrinth of conflicting 
means selects that which most surely leads to the end in view. 
His was, indeed, eminently a practical mind, looking always to 
acts rather than to opinions, and disposed to measure the value of 
any system or project by its probable bearing on the condition of 
society or individuals, not by its mere beauty, or the ingenuity dis- 
played in its invention. 

But, while thus marked with strikiug traits, he was not without 
the graces also of character. His amiableness of temper, candour 
and openness of heart, liberality of sentiment, charity for the fail- 
ings of others, warmth and constancy in friendship, and love of 
order and punctuality, were often beautifully illustrated in his daily 
intercourse, and contributed to give him the charm of manner 
which rendered his presence everywhere so acceptable. The real 
politeness for which Dr. Parrish was remarkable, was in no respect 






A MEMOIR OF DR. JOSEPH PARRISH. 421 

the result of cultivation, but flowed directly from the fountain of 
his own kindly feelings. It was the genuine coinage of nature, 
which art may counterfeit, but seldom equals. With a self-posses- 
sion resulting from his utter want of pretension, and the perfect 
simplicity of his character, and entirely free from that sort of diffi- 
dence of manner which is the frequent result of pride, he was never 
awkward in speech or movement, and in all the intercourse of life 
exhibited the deportment of a true gentleman. 

To the present audience, it is scarcely necessary to recall the 
personal characteristics of Dr. Parrish ; his fine, open, benevolent 
countenance, with small but expressive eyes, beautiful teeth, and 
generally regular features ; his form rather below the medium 
height and slightly stooping, but broad, full, well made, and 
vigorous; his gait rapid and energetic, as if in the eager pursuit 
of some important object ; his garb, that of the sect to which he 
belonged, and simple according to its strictest requisitions. 

Having thus endeavoured to portray our late friend as a man, 
we are next to consider him in his professional capacity as a physi- 
cian and a medical teacher. In the narrative of his progress in 
life already given, allusion has been so often incidentally made to 
those traits of his character which distinguished him as a practi- 
tioner of medicine, that comparatively little need be said on the 
present occasion. That little may be included under the several 
heads of his relations, first, to the disease, secondly, to the patient, 
and thirdly, to his fellow-members of the profession. 

He was peculiarly skilful in diagnosis. His acuteness of obser- 
vation led him often to notice symptoms or circumstances, which, 
though apparently trifling, and therefore liable to be overlooked 
by a careless eye, were yet of the highest importance towards the 
formation of a correct notion of the disease. He was at the same 
time careful not to decide rashly in doubtful cases, and was espe- 
cially cautious in surgical affections, in which a hasty opinion 
might lead unnecessarily to serious operations. An instance of 



422 A MEMOIR OF DR. JOSEPH PARRISH. 

his acumen in diagnosis, familiar to most of his pupils, deserves 
perhaps to be mentioned here. He was invited to be present at 
an operation for the removal of a cancerous tumour of the breast. 
The surgeons had met, and the operator was about to proceed, 
when Dr. Parrish, having made an examination, and been induced 
to suspect the existence of a deep-seated scrofulous abscess, men- 
tioned privately his views of the case, and suggested that, pre- 
viously to the use of the knife, a lancet should be thrust deeply 
into the tumour. This was assented to, as at all events a safe ex- 
pedient, though rather in compliance with the wish of the Doctor 
than from a conviction of its propriety. A puncture was accord- 
ingly made, and a copious flow of pus followed the withdrawal of 
the instrument. The patient was thus saved a painful operation, 
and the surgeon the no less painful mortification which would have 
ensued, had he attempted the extirpation of the tumuor, and found 
himself in the midst of an abscess. 

The extensive experience of Dr. Parrish, and his tenacious me- 
mory, enabled him frequently to pronounce promptly, in cases con- 
sidered doubtful, by recalling others of a similar nature which had 
occurred to him ; and this process of inference by comparison was 
so rapid, that his conclusions often appeared, to himself perhaps 
as well as to others, the result rather of intuition than of an intel- 
lectual operation. 

A few years since, there appeared in the lower parts of our city 
numerous cases of a disease, which bore some resemblance to the 
common nervous or typhoid fever, but was more violent, and pre- 
sented pathological characters which seemed to mark it as a quite 
different affection. Dr. Parrish was consulted, and at once pro- 
nounced the disease to be the same typhus fever of which he had 
seen so much when it prevailed here epidemically in 1812, and sub- 
sequent years, but which had for a long time almost wholly disap- 
peared. The result of the treatment in these cases confirmed the 
correctness of the diagnosis. Active stimulation was found to be 



A MEMOIR OF DR. JOSEPH PARRISH. 423 

requisite ; while bleeding, which is often well borne in the ordinary 
typhoid fever, was seldom admissible.* 

His correct judgment also was eminently serviceable to him in 
the investigation of disease. Though few circumstances connected 
with any case escaped his observation, yet, so far from being em- 
barrassed by the multitude of different and often seemingly con- 
flicting materials for an opinion, he had the talent of throwing out 
of view all but the important points, and was thus enabled to come 
to a satisfactory and usually just conclusion, when others of equal 
or superior knowledge, but less accuracy of judgment, were left in 
uncertainty, or led into error. 

The same good sense caused him to look always to the practical 
and useful in his estimate of disease. Though willing to explain 
facts in the manner which appeared to him most consonant with 
reason, he was utterly averse to mere speculation, and never 
allowed a theory, however plausible, to exert any influence over 
his decisions, when extended beyond the limits of rigid observation 
into the fields of mere conjecture. To the medical doctrines which 
arose in rapid succession during his life, and which, in some in- 
stances, exerted a wide-spread and not innoxious influence over the 
profession, he opposed a steady and active resistance, believing it 
to be his duty to protect not only himself, but others also, so far as 
lay in his power, from their fascinations. It was not that he dis- 
liked them merely as novelties. On the contrary, no one seized on 
newly- announced facts, or well-attested observations, more eagerly 
than himself; and ancient hypotheses had no more favour in his 
eyes than those of recent origin. But he was convinced that no 

* The diagnosis was positively confirmed by a careful comparison of the 
symptoms and course of the two affections, and by the results of post-mor- 
tem examinations. It was, indeed, through the investigations made at this 
period, that Dr. W. W. Gerhard was enabled to establish the diagnosis be- 
tween typhus and typhoid or enteric fever, and to determine the distinct 
nature of the two affections. [December, 1850.) 



424 A MEMOIR OF DR. JOSEPH TARRISH. 

general theory of disease can be true, because we are not yet in 
possession of the materials out of which to form such a theory, and 
it has not been given to man to penetrate by conjecture the coun- 
sels of creative wisdom ; and he believed that false hypotheses are 
productive of the most dangerous practical results. He was in 
favour, therefore, of patiently making and recording observations, 
and only then attempting to deduce general truths, when the facts 
accumulated were sufficient for the purpose, without the necessity 
of a resort to supposition or conjecture. Happily, he lived to see 
this system of prosecuting medical inquiry become the fashion 
among us ; and I have no doubt that, so far as concerns this 
place, the result may in some measure be ascribed to his efforts. 

The peculiar intellectual qualities which aided him in the study 
of disease were no less useful to him in therapeutics, in which 
also he exhibited the same preference of experience over the sug- 
gestions of abstract reasoning, or the inventions of imagination. 
Though by no means distrustful of the powers of medicine, he yet 
had great confidence in the native resources of the system, and was 
much in the habit of relying on them in his course of treatment. 
He watched carefully for the indications which nature might pre- 
sent, and not unfrequently answered these indications, though op- 
posed to general opinion, or even to his own preconceived views. 
He attached great importance to the constitutional peculiarities of 
individuals, which he studied with care, and always consulted in 
his choice of remedies. The ordinary means by which life and 
health are sustained, such as pure air, cool drinks, wholesome 
food, a regulated temperature, exercise, etc., frequently became in 
his hands powerful therapeutical agents, especially in cases which 
seemed to have originated in the want of them. Yet when medi- 
cines appeared to be demanded, he was prompt and efficient in 
their use ; and was often very happy in the selection of those best 
adapted to the case, being greatly aided in his choice by a peculiar 



A MEMOIR OF DR. JOSEPH PARRISH. 425 

sagacity, which suggested new modifications or contrivances to 
meet unforeseen emergencies, or unusual states of disease. 

To the practice of surgery he was admirably adapted by these 
same qualities, and, in addition, by those essential physical requi- 
sites, a good eye, a steady hand, and general firmness of nerve. I 
never but once saw his hand tremble under any circumstances of 
health or sickness. He used to have some pride in this important 
surgical qualification ; and I have frequently seen him, even when 
exhausted by severe and long-continued illness, hold out his hand 
in the position in which it was wont to grasp the knife, without 
the slightest discoverable motion other than that produced by the 
arterial pulsations. He used to say that, when he should perceive 
his hand to shake under these circumstances, he should consider it 
as an evidence that he was near his end ; and surely enough, in his 
last illness, a very short time before his death, while he was almost 
unconsciously repeating the same trial of his strength of nerve, I 
observed for the first time that failure which he considered so 
ominous. 

Towards the sick the deportment of Dr. Parrish was most happy. 
The cheering smile with which he accosted his patients, his sooth- 
ing kindness, his encouraging and confident manner while there was 
still ground for hope, and his affectionate sympathy and consola- 
tion when hope was over, remain indelibly impressed on the grate- 
ful recollections of thousands in this city. In dangerous cases, he 
was candid whenever there was not reason to fear that by being so 
he might greatly aggravate the danger ; and he never undertook a 
hazardous operation, without having previously made the patient 
acquainted with his condition, and obtained his consent, with a full 
knowledge of the possible consequences. When thus called upon 
to be the herald of danger, the kindness of his heart pointed out 
the mode of proceeding least likely to occasion unnecessary pain ; 
and his well-known character as a pious man enabled him to mingle 
very effectively the consolations of religion with the gloomy intelli- 



426 A MEMOIR OF DR. JOSEPH PARRISH. 

gence which he had to announce. He was frequently consulted 
by his patients, in the capacity of a friend and counsellor as well 
as physician, and thus became the confidant of many private con- 
cerns, which he always considered as a sacred trust committed to 
his honour. He was scrupulously careful never to violate profes- 
sional confidence. Nothing ever passed his lips which could affect 
the reputation of those who had placed themselves in his hands ; 
and, when there was something in a case interesting in a profes- 
sional point of view, which, however the patient might wish to be 
concealed, he was most cautious, in relating the fact for the benefit 
of his pupils, not to mention the name, and even to avoid every 
allusion which could by any chance connect the event with the indi- 
vidual. When such a connection was unavoidable he was entirely 
silent; for he considered that no good which might possibly accrue 
to society from the publication, or promulgation in anyway, of any 
particular case, could justify a physician in violating even an im- 
plied trust. Upon his students he was always exceedingly solicitous 
to inculcate the great importance of professional secrecy, not only 
as essential to the respect of the world, but as in the highest degree 
binding upon their honour and conscience. 

I have already spoken of his liberality towards patients of slen- 
der means, and the delicacy with which his favours were conferred. 
This conduct arose from feeling and principle, and not from mere 
carelessness in relation to pecuniary concerns ; for in all his busi- 
ness transactions he was scrupulously exact, and, in relation to his 
fees for medical services, considered it a duty which he owed as 
much to his patients and the profession as to himself, to present 
his accounts regularly once a year, whenever peculiar circumstances 
did not require some relaxation of his general rule. He always, 
however, considered these accounts in the light of honorary claims, 
and not only never exacted payment, but declined it altogether 
when the patient expressed any doubt of its justice, or any great 
unwillingness to discharge it. I recollect being present, on one 



A MEMOIR OP DR. JOSEPH PARRISH. 42? 

occasion, when a countryman of some wealth, and no less covetous- 
ness, called at his house to settle a bill for medical attendance. 
He was probably not accustomed to the rate of charging common 
in the city, and demanded some abatement from the account on 
the score of its extravagance. The Doctor in reply told him that, 
if such were his views, he should decline receiving anything ; where- 
upon the gentleman, commending his liberality, took up his hat and 
left the house, apparently very well contented. 

Perhaps in no respect did Dr. Parrish appear to greater advan- 
tage than in his relations with his medical brethren. It was one 
of his maxims that no physician could have a satisfactory profes- 
sional standing, who disregarded the good-will and good opinion 
of his fellow- practitioners. He was, therefore, mindful of their 
rights on all occasions, never allowing any chance of immediate or 
prospective advantage to himself to interfere with their just inter- 
ests, and very often going out of his way to protect their reputa- 
tion, and to repair any injury they might have suffered in the esti- 
mation of their patients. He held in abhorrence that meanness of 
spirit which, for a little apparent profit, would insinuate evil of a 
brother, or even assent by silence to a mistaken estimate of his 
worth. He was strictly obedient to the ethical code, which wise 
and good physicians have established for the regulation of their 
intercourse with their patients and with one another, and which, 
however liable to reproach from selfishness or inexperience, is yet 
indispensable to the maintenance of harmony in our profession, and 
consequently to efficiency for the public good. No medical man 
could long remain in a hostile attitude towards Dr. Parrish. I do 
sincerely believe that he never purposely gave cause of offence to 
a fellow-practitioner; and any temporary ill-will, which may have 
originated in misconception, soon melted away before his amenity 
of manner and obvious goodness of heart. He never resented an 
injury, real or supposed, and not unfrequently repaid unkindness 
with benefits. 



428 A MEMOIR OF DR. JOSEPH PARRISH. 

From his regard for his fellow-practitioners, it may be inferred 
that lie had pleasure in meeting them in consultation. He had 
none of the jealousy which fears a rival in every person with whom 
we may be associated in attendance, nor of the overweening and 
arrogant self-esteem which owns no fallibility of judgment. It was 
his custom, whenever he supposed a patient or his friends might 
desire additional aid, or when the case was one of a doubtful or 
embarrassing nature, to offer a consultation ; and when a sugges- 
tion to this effect came from the patient himself, he always promptly 
gave his assent, however inferior in age and standing mi it be his 
proposed associate. 

Another trait, which favourably distil rished his i course 
with the profession, was an extraordinary mctuality in ie fulfil- 
ment of his engagements. In consultati s he very rarely failed 
to meet at the time appointed ; and so j •■ us was he of his char- 
acter in this respect, that it was a habit ith him, which most of 
his medical friends must remember, to p ent his watch when he 
was second in entering the house, in order to prove that he was 
not after his time. 

Towards the younger members of the profession, he conducted 
himself in a manner calculated to win their affection as well as 
respect. So far from feeling the least touch of jealousy at their 
success, or exhibiting any of that overbearing temper which some- 
times attends an increase in years and honours, he was always 
gratified with an opportunity of promoting their interests, and 
regulated his intercourse with them upon the same principles as 
with his equals in age. He did not consider the tie between him- 
self and his pupils broken, when they had established themselves as 
practitioners. On the contrary, he felt towards them as towards 
younger brothers, rejoiced in their professional advancement, aided 
them by his advice and recommendation, and took every oppor- 
tunity of causing the superabundance of his own cup to flow over 
into theirs. It was a fine trait in his character, and one which has 



A MEMOIR OF DR. JOSEPH PARRISH. 429 

endeared him to many now present, that when any of his young 
friends, through accident or other cause, acquired a footing in 
families which he had been in the habit of attending, instead of 
feeling unkindly or endeavouring in any way to interfere with their 
interests, he seemed to enjoy their success, and took pains to 
strengthen the impressions in their favour, through the influence 
which his long professional intercourse with the families naturally 
gave him, I know that there are many, who will heartily join me 
in this tribute of acknowledgment to the memory of our deceased 
benefact* .: : . and friend. But I feel that on my own part the tribute 
is inade< ^ate. When I call to mind his virtues, his many amiable 
qualitif and his numberless acts of personal kindness ; how he 
took m by the hand v ben young, admitted me into his intimate 
confidence, attended n .in illness, counselled and aided me when 
counsel and aid were ./f^ded, and throughout life gave me his 
warmest sympathy, my -east is filled with emotions which exceed 
the powers of language »nd I cannot but feel, that my efforts to 
exhibit him to others witii all his admirable characteristics as they 
present themselves before me, are as futile as would be an attempt, 
without the talents of a painter, to transfer to the canvas the vivid 
image of his form and features impressed upon my memory.* 



* In view of certain untrue statements which have appeared in print, in 
relation to my earlier life, I may, perhaps, he permitted here to say that the 
aid, referred to in the text, was purely professional. I never received, as I 
never needed, pecuniary assistance from Dr. Parrish. Our relations were as 
nearly as possible, without any blood-connection, those of an elder and a 
younger brother; at least my feelings of respect and affection towards him 
were such as would naturally arise out of such a relation; and I have reason 
to think that they were fully reciprocated on his side. During our long 
intercourse, whatever might be our differences of opinion, there was an 
unbroken intimacy; and, in his last illness, he showed his continued confi- 
dence by putting himself under my professional care, jointly with that of our 
mutual friend, Dr. John C. Otto. {December, 1859.) 



430 A MEMOIR OF DR. JOSEPH PARRISH. 

A few words in relation to the peculiarities of Dr. Parrish as a 
teacher, will close this imperfect representation of his medical char- 
acter. Without having cultivated either rhetoric or oratory as an 
art, he was a fluent and by no means inaccurate speaker, and, when 
under the impulse of high principle or strong feeling, was often 
truly eloquent, attracting the fixed attention of the audience, and 
carrying their whole sympathies along with him. It appeared as 
if his own beautiful feelings were personified in the speaker, and 
that the hearers were listening to the very voice of benevolence, 
of charity, of compassion for the weak and suffering, of indignation 
against oppression, or of whatever other emotion was at the time 
predominant within him. On such occasions, as he was under no 
restraint from the rules of art, and unembarrassed by the conscious- 
ness of any evil in his own thoughts, he surrendered himself freely 
to the current of his emotions, which, as they were themselves pure, 
threw up to the surface nothing which required concealment. 

This pouring out unreservedly of all that he thought or felt, con- 
stituted the main charm also of his medical lectures. His instruc- 
tions did not consist of laboured treatises upon disease, presenting 
in a regular and compact arrangement all that was known upon 
the subject. They were rather vivid pictures of his experience, in 
which the pupil was enabled to see the very events as they passed, 
and to see them too with the trained eyes of their preceptor. They 
were made to enter into the very case, to share in the reflections, 
hopes, and fears of the speaker, and thus to take an almost per- 
sonal interest in the progress and termination of the disease. His 
lessons became in fact to his pupils a sort of experience of their 
own ; and I think it probable that many of us, who have been long 
in practice, would find some difficulty in discriminating between 
the recollection of what we have ourselves seen, and the strong 
impressions left upon our minds by the representations of our 
teacher. 

Through his lectures there ran a vein of cheerful good-nature, 



A MEMOIR OF DR. JOSEPH PARRISH. 431 

enlivened with frequent touches of humour, which added much to 
their attractiveness. By his very mode of accosting his pupils 
upon entering the lecture-room, he contrived to place them upon 
a footing of friendly familiarity, which disposed them to attend to 
his instructions out of personal regard for the speaker, as well as 
from a desire to learn. "Well, boys," he would say, preparatory 
to some kindly greeting, or some friendly inquiry, and thus by a 
few words expressive of his own good feeling, attuned their minds 
into harmony with his own, and was enabled to carry their hearts, 
as well as their attention, along with him in his subsequent ad- 
dress. 

But the feeling of familiar companionship, with which he in- 
spired his pupils by his deportment towards them on all occasions, 
never passed the limits of perfect propriety. It was so mingled 
with reverence for his purity of heart, and elevation of character, 
that nothing but the spirit of evil could have, suggested anything 
likely to prove offensive to him ; and the guard which the student 
was thus induced to keep over any wrong propensity, in the midst 
of the otherwise unreserved intercourse with his preceptor, had the 
tendency to modify his own character favourably, and to make him 
in reality what he wished to appear. 

In his lectures Dr. Parrish was accustomed to introduce numer- 
ous illustrative cases, and endeavoured to strengthen the effect of 
mere description by the exhibition of pathological specimens, which, 
in the long course of his practice, he had been enabled to procure 
in great numbers. Indeed, his collection of diseased bones was 
probably unequalled in any cabinet, public or private, in this coun- 
try. He strove also constantly to direct the attention of his pupils 
to the practical observation of disease, and to the attainment of 
familiarity with all the instruments and means of cure. With 
the latter view, he recommended them to spend some months in 
the shop of an apothecary, in the earlier period of their studies, 
and to seize every opportunity of performing those minor opera- 



432 A MEMOIR OF DR. JOSEPH PARRISH. 

tions, and exercising those manipulations, a perfect facility in which 
is so important to the practitioner, and especially to the surgeon. 
He urged upon them, moreover, a regular attendance at the hos- 
pitals, and, in his own private practice, sought occasions to enable 
them to see disease, to assist at operations, and in various ways to 
initiate themselves into the practical duties for which they were 
preparing. 

On the whole, few men have, I believe, exhibited a stronger in- 
terest in their pupils, or laboured more assiduously to promote 
their welfare ; and no one, certainly within my own observation, 
has gained a more ample return of love and respect. 

Having thus given a historical sketch of Dr. Parrish up to the 
period of his last illness, and endeavoured to delineate his char- 
acter as a man, a physician, and a medical teacher, it now only 
remains for us to consider him in the closing scene of his life. 
This is the touchstone which tries the value of the past, and dis- 
tinguishes what was sterling worth from the false glitter of profes- 
sion, and the deceptions of self-esteem. He only can be said to 
have been truly happy in life whose end is happy. To the friends 
of Dr. Parrish it is a source of the purest satisfaction, that he 
passed successfully through this last and severest trial, and that 
the close of his career was in harmony with its whole course. He 
was attacked in the summer of 1839 by the disease which ulti- 
mately proved fatal, but continued to attend to his various avoca- 
tions, though somewhat irregularly, till about the beginning of the 
present year, when he confined himself to his house, on account of 
a severe bronchial affection superadded to his former complaint. 
From this he partially recovered, so as to be able to drive out occa- 
sionally, and even visit patients; but he suddenly became worse 
about the close of February, and, taking to his bed, continued to 
sink gradually for nearly three weeks, and died on the 18th of 
March, in the sixty-first year of his age. Though somewhat 
lethargic towards the conclusion of the disease, he was capable, 



A MEMOIR OF DR. JOSEPH PARRISH. 433 

when roused, of thinking with perfect clearness, and of fully ap- 
preciating his condition, till a day or two before death. In the 
midst of much bodily distress, and great derangement of his ner- 
vous system, he preserved unimpaired those amiable traits of char- 
acter by which he was distinguished in health, frequently expressing 
a grateful sense of the kindness of those who administered to him, 
and carefully avoiding any expression which could wound their 
feelings. With the full conviction of the fatal character of his 
disease, and with the near prospect of its termination, he was per- 
fectly calm and self-possessed, made all the requisite arrangements 
in his affairs, spoke to his family as a tender husband and father, 
solicitous for their present and eternal welfare, might be expected 
to speak, and uniformly expressed his reliance upon the goodness 
and mercy of Providence, and his hope of a happy hereafter. 
Under the feeling of his utter bodily prostration, he used to say 
to his physicians that he was like a log of wood on the Delaware, 
floating about at the discretion of the winds and tides. At one 
of their latest visits, when hearing and sight were failing, and the 
power of articulation was almost gone, he repeated this expressive 
figure, and could but just be heard to say in addition, "but even 
the log on the Delaware has its care-taker." Thus, the reliance 
upon a superintending Providence, which was one of the governing 
principles of his life, did not fail him in death ; and, if love for his 
fellow-men, unceasing beneficence, and a reference in almost all that 
he said and did to the will of his Maker, may be considered as the 
indications of a spirit prepared for immortality, his friends may 
confidently indulge the belief, that, in dying, he has but exchanged 
the uncertain gratifications of this world for the sure happiness of 
that to come. 

The almost unprecedented array of his fellow-citizens of all 
classes who attended his remains to the grave, the general expres- 
sion of regret for his loss, and the measures taken by the various 
bodies to which he belonged, to procure some public commemora- 



434 A MEMOIR OF DR. JOSEPH PARRISH. 

tion of his worth and services, are evidences of a general esteem 
and affection such as seldom fall to the lot of individuals, uncon- 
nected with public life. Perhaps no one was personally known 
more extensively in the city, or had connected himself, by a greater 
variety of beneficent service, with every ramification of society. It 
is true that no marble has been erected over his remains, and that 
the very spot where they are laid will soon be undistinguishable to 
every eye save that of conjugal or of filial love ; yet the remem- 
brance which he has left behind him, the only monument which the 
rules of his unostentatious sect allow, is far more precious than the 
praises of carved stone, which gold may purchase, or power com- 
mand. Should this humble tribute to his worth add in the least to 
the brightness or the duration of that remembrance, the author will 
feel the sweet reward of having paid a double debt, to gratitude 
and to truth. 



A BIOGRAPHICAL MEMOIR 

OP 

SAMUEL GEORGE MORTON, M.D., 

READ BEFORE 

THE COLLEGE OF PHYSICIANS OF PHILADELPHIA, 

NOVEMBER 3d, 1852. 



In accepting the appointment with which the College honoured 
me, of preparing a biographical sketch of our late Fellow, Dr. 
Samuel George Morton, it may be remembered that I requested 
indulgence on the score of time ; as the urgency of my then exist- 
ing engagements rendered immediate attention to the duty impos- 
sible. The delay has been longer than I could have wished ; but, 
happily, there was little occasion for haste, as the Academy of 
Natural Sciences, with which, through official position and long 
co-operation, Dr. Morton was more closely connected than with 
any other public body, had already provided for that commemora- 
tion which society owed to him, as to one who had faithfully and 
honourably served it. In what manner this duty was fulfilled need 
not be told to those who have perused the memoir, prepared by 
Dr. C. D. Meigs, so characteristic of the author in its easy and 
copious flow of expression, its genial warm-heartedness, its glow- 
ing fancy, and the cordial, unstinted appreciation of the merits of 
its subject. It may be proper to mention here, that to this me- 

(435) 



43G A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

raoir I am indebted for many of the following facts. Having been 
prepared under the auspices of an association devoted to the 
natural sciences, though treating of our departed colleague with 
greater or less fulness in all his relations, it very appropriately 
directs a special attention to the scientific side of his life and cha- 
racter. With equal propriety, as appears to me, a professional 
body like the present may expect a particular reference to his 
medical history ; and I shall, accordingly, endeavour to place him 
before you, rather as a physician than as a man of general science. 
It was in the former capacity that Dr. Morton was best known to 
the writer, who had the honour of aiding in the conduct of his 
early medical studies, was afterwards for a time associated with 
him as a medical teacher, and, throughout his whole professional 
life, maintained with him a frequent and friendly intercourse. 

The delineation which follows is necessarily in miniature ; for, 
independently of the comparatively short time which can be de- 
voted to such communications in the business of the College, the 
pages of our journal, to which it is customary in the end to con- 
sign them, are too limited to receive in its fulness a portraiture, 
which might readily be made to occupy volumes. I shall, how- 
ever, endeavour, by excluding irrelevant commentary, and by ex- 
pressing myself as concisely as possible, to introduce within the 
limits assigned the greatest practical amount of biographical 
matter. 

Dr. Morton sprang from a highly respectable family, residing at 
Clonmel, in Ireland. His father, George Morton, the youngest 
of four brothers, emigrated at the age of sixteen to this country, 
with another brother somewhat older, who soon afterwards died. 
He settled in Philadelphia, and, having acquired the requisite ex- 
perience in a counting-house in a subordinate capacity, afterwards 
engaged in mercantile business on his own account. Here he mar- 
ried Jane Cummings, a lady having a birthright in the religious 
Society of Friends, which, according to a well-known rule of that 






A MEMOIR OF DR. SAMUEL GEORGE MORTON. 43 Y 

Society, she lost upon her marriage with one who was not a mem- 
ber, Mr. Morton belonging to the English Church. He died on 
the 2Tth of July, 1199, leaving his widow with three children, a 
daughter and two sons, the youngest of whom was the subject of 
the present sketch, and at that time an infant in arms. The older 
boy, James, was soon afterwards sent to an uncle in Ireland, who 
adopted him ; but he died before maturity. The sister still sur- 
vives to lament the loss of both her brothers. 

Dr. Morton was born on the 26th of January, 1199, and was 
consequently about six months old at the death of his father. In 
her bereavement the widow sought consolation in religion, and, 
still entertaining the faith in which she had been educated, applied 
for restoration of membership in the Society of Friends, and was 
received. With a view to be near a beloved sister, she removed 
from Philadelphia to West Chester, in the State of New York, but 
a few miles from the metropolis, where her sister resided. Wish- 
ing that her children should be brought up in her own religious 
faith, and surrounded in early life by those safeguards which are 
eminently provided by the discipline of Friends, she sought for 
their admission into the Society ; and they were accordingly re- 
ceived as if members by birth. 

Custom, if not positive rule, requires among Friends that chil- 
dren should as far as practicable be educated in schools under the 
care of the Society, so that their tender years may be protected 
until their principles shall have sufficiently taken root to resist the 
seductions of the world. As no school of this kind existed in her 
immediate neighbourhood, Mrs. Morton felt herself compelled, 
when no longer satisfied with her own tuition, to send her young 
son from home ; and, for several years of her residence at West 
Chester, he was placed in one or another of the Friends' boarding- 
schools in the State of New York, where he acquired the usual 
rudiments of an English education. 

At this early age, the boy evinced a literary turn of mind, being 



438 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

extremely fond of historical reading, and frequently trying his 
hand in writing verses, an exercise very useful to the young, by 
giving them a command of language not so easily attained in any 
other way. I am told that his bent towards natural science was 
also received at this period. Among the visitors of his mother 
was Thomas Rogers, a gentleman belonging to the Society of 
Friends living in Philadelphia, who had a great fondness for mine- 
ralogy, and imparted a portion of the same fondness to the young 
son of his hostess, whom he delighted to take with him in his ex- 
ploratory walks in the neighbourhood. 

The visits of Mr. Rogers resulted in his marriage with Mrs. 
Morton, and her return with him to Philadelphia, along with her 
two children, whom he loved and treated as if they were his own. 
Dr. Morton always spoke in the kindest and most affectionate 
terms of his step-father. He was about thirteen years old when 
this change took place. 

After the removal to Philadelphia, he was sent for a time to the 
famous boarding-school of Friends at West Town, in Chester 
County, Pennsylvania; and subsequently, in order to complete his 
mathematical studies, to a private school in Burlington, New 
Jersey, under the care of John Gummere, a member of the Society 
of Friends, and eminent as a teacher. 

Having remained for one year under the instruction of Mr. 
Gummere, he left the school, in the summer of 1815, and entered 
as an apprentice a mercantile house in this city, in which he con- 
tinued until the death of his mother in 1816. 

His heart was not in his business; and, though there is no 
reason to believe that he neglected the duties of his position, he 
devoted most of his leisure hours to reading, and gave his thoughts 
rather to history, poetry, and other branches of polite literature, 
than to mercantile accomplishment. 

The last illness of his mother was protracted, requiring the fre- 
quent attendance of physicians; and several of the most distin- 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 439 

guished practitioners of Philadelphia were in the habit of visiting 
her professionally. Drs. Wistar, Parrish, and Hartshorne were 
men calculated to impress favourably the mind of a bright, and at 
the same time thoughtful youth ; and the attentions they paid to 
him, elicited no doubt by their observation of his intelligence and 
studious tendencies, had the effect of greatly strengthening the im- 
pression. His respect and affection for these eminent physicians 
naturally inclined him to their profession, and suggested the wish 
that he might be prepared to tread in their footsteps. This, I am 
informed, is what first directed his thoughts towards the study of 
medicine ; though, as stated by Dr. Meigs, it is not improbable 
that the reading of the published introductory lectures of Dr. Rush 
may have been the immediate cause of his change of pursuit. 

In the year 1811, being in the nineteenth year of his age, he 
entered as a pupil into the office of the late Dr. Joseph Parrish, 
then in the height of his practice, and distinguished as a private 
medical teacher. It was here that I first formed his acquaintance, 
being about to close my pupilage under the same preceptor, when 
he began his. As I was, soon after graduation, engaged by Dr. 
Parrish to aid him in the instruction of his rapidly increasing 
class, I had, both as a companion and teacher, the opportunity of 
witnessing the industry and quick proficiency of the young student, 
and formed a highly favourable opinion of his general abilities. 
He attended the lectures in the University of Pennsylvania regu- 
larly, and, having complied with the rules of the institution, 
received from it the degree of Doctor of Medicine, at the com- 
mencement in the spring of 1820. 

During the period of his medical studies, he continued to reside 
with his step-father, and to this association probably owed in part 
his continued predilection for the natural sciences. It was to be 
expected from such a predilection, that he would give especial at- 
tention to anatomy, which, indeed, he cultivated with much dili- 
gence and success. Similarity of taste and pursuit in this respect, 



440 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

led to a friendly association, about this period, with the late Dr. 
Richard Harlan, who superintended the anatomical studies of Dr. 
Parrish's pupils, and subsequently became distinguished as a 
naturalist. 

Soon after his graduation, Dr. Morton became a member of the 
Academy of Natural Sciences, thus commencing his professional 
career as a member of that body, over which he presided at the 
time of his death. 

Having been pressingly invited by his paternal uncle, James 
Morton, of Clonmel, before commencing the practical duties of 
life, to pay a visit to his relatives in Ireland, and eagerto improve 
both his professional knowledge and his knowledge of the world, 
he concluded to make a voyage to Europe, and accordingly em- 
barked for Liverpool in May, 1820. On arriving in England, he 
proceeded immediately to Clonmel, where he spent about four 
months in a delightful intercourse with friends and relatives pro- 
verbially hospitable, improving in manners through the polishing 
influence of refined society, and cultivating his taste by varied read- 
ing. It is probable that, in this association, whatever bent his 
mind may have received, from early education, towards the peculiari- 
ties of Quakerism, yielded to the influences around him ; for though, 
throughout life, he reaped the advantages of that guarded educa- 
tion, in an exemplary purity of morals, and simplicity of thought 
and deportment, he connected himself subsequently with the Epis- 
copal Church, to which his forefathers had been attached. 

The uncle of Dr. Morton very naturally valued a European de- 
gree more highly than an American, and was desirous that his 
nephew, before entering on his professional career, should obtain 
the honours of the Edinburgh University. The Doctor yielded to 
his wishes, and left his Irish friends, to enter upon a new course of 
medical studies at the Scotch capital. In consequence of exposure, 
in his journey from Dublin to Belfast, on the top of a coach, he was 
seized with an illness, believed to be an affection of the liver, which 



A MEMOIR OP DR. SAMUEL GEORGE MORTON. 441 

confined him for some time to his bed in Edinburgh, and probably 
served as the foundation of that delicacy of health, which attended 
him for the rest of his life. On his recovery, he commenced an 
attendance upon the medical lectures, and at the same time upon 
those of Geology by Professor Jamison, thus showing that his 
attachment to natural science still continued. 

Another attack of illness, early in the year 1821, interrupted his 
studies. Recovering from this, he made an excursion into the 
Highlands of Scotland, and afterwards returned to the relaxation 
and enjoyments of a residence among his friends at Clonmel. 

In the autumn of the same year, he made a journey to Paris, 
where he spent the winter very profitably in the prosecution of his 
studies, and in improving his knowledge of the French language. 

In the following spring, he left Paris upon a tour through France, 
Switzerland, and Italy, in which he consumed the summer. 

In the autumn of 1822, we find him again at Edinburgh, where 
he continued through the winter, attending lectures, making up for 
early deficiencies in classical education by the study of Latin, and 
otherwise preparing himself for graduation. Having written and 
presented a thesis in Latin, De Corporis JDolore, and undergone 
satisfactorily an examination on medicine in the same language, he 
received the honours of the University in August, 1823. 

He had thus been six years occupied, more or less steadily, in 
the study of medicine, carrying on, during the same period, a pro- 
cess of self-education, which more than compensated for the de- 
ficiencies of his early life, and attaining a proficiency in various 
branches of natural science, which contributed greatly to his future 
eminence. 

In June, 1824, he bade farewell to his friends in Ireland, and, 
returning to Philadelphia, immediately engaged in the practice of 
his profession. 

His success was gradual. Young physicians are apt to complain 
of their slow progress in a remunerative business ; but what they 



Ill' A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

consider a misfortune is in fact, if properly used, a blessing. Their 
early years have been devoted to the acquisition of elementary 
knowledge, their later will be occupied by practical duties. It is 
iii the intermediate period that the opportunity is offered of ex- 
tended research into the records of science, of confirming or cor- 
recting the results of reading and study by observation, of making 
original investigations into the worlds of matter and of thought, 
and thus bringing forth to the light truths which may benefit man- 
kind, and at the same time serve as the basis of honour and success 
to their discoverer. He who leaps at once from professional study 
into full professional action, finds all his time and pow r ers occupied 
in the application of the knowledge already attained, and seldom 
widens materially the circle of science, or attains higher credit than 
that of a good, or a successful practitioner. It was undoubtedly 
fortunate for Dr. Morton's reputation, that his time was not, at the 
outset, crowded with merely professional avocations. He had thus 
the opportunity of going out into the various fields of natural 
science; and, while he neglected none of the means requisite to 
the honourable advancement of his business as a physician, he 
pushed his researches and labours in those fields to the most 
happy results. 

As an aid and stimulus to his researches in this direction, he 
entered at once into hearty co-operation with his fellow-members 
of the Academy of Natural Sciences, and took an active part in 
the affairs of that institution. He was almost immediately made 
one of the auditors; in December, 1825, was appointed to the 
office of Recording Secretary, which he held for four years ; served 
actively for a long time on the Committee of Publication; aided 
materially in increasing and arranging the collections ; delivered 
before the Academy lectures on mineralogy and geology during 
the years 1825 and 1826; drew up a report of its transactions for 
these two years ; and began a series of original papers upon various 
subjects of natural science, which have contributed greatly to his 
own credit, and that of the institution. 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 443 

His first medical essay was on the use of cornine in intermittent 
fever, and was published in the Philadelphia Journal of the Medi- 
cal and Physical Sciences (xi. 195, a.d. 1825). Under the name 
of cornine, a material had been given to him, purporting to be an 
alkaline principle extracted from common dogwood bark, and, 
having been used by him in several cases of intermittent fever, 
proved to be an efficacious remedy. Dr. Morton was responsible 
only for the correctness of his own statements as to the effects of 
the substance given to him, and not for its chemical character, 
which must be admitted to be at best doubtful. Positive proof is 
still wanting of the existence of any such active alkaline principle. 

His first strictly scientific papers were two in number, both read 
on the 1st of May, 1827, before the Academy of Natural Sciences, 
and afterwards printed in the Journal of the Academy. They 
were entitled respectively, "Analysis of Tabular Spar, from 
Bucks County, Pennsylvania, with a notice of various minerals 
found at the same locality," and "Description of a new species 
of Ostrea, with some remarks on the Ostrea convexa of Say." 

These were followed in rapid succession by other scientific com- 
munications ; and the Transactions of the Academy continued to 
be enriched by his labours from this date till within a short period 
before his death. There were not less than forty of these contri- 
butions, besides others to the Transactions of the American Phi- 
losophical Society, and the American Journal of Science and 
Art, edited by Professor Silliman. They were on the various sub- 
jects of mineralogy, geology, organic remains, zoology, anatomy, 
ethnology, and archaiology; and, by their diversified character, 
richness in original matter, and accuracy and copiousness of de- 
scription, speak more strongly than could be done in mere words 
of the industry, scientific attainments, powers of observation, and 
truthfulness of their author.* 

* For a catalogue of these and of the other works of Dr. Morton, the 
reader is referred to the Appendix of the Memoir prepared by Dr. Meigs. 



444 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

But, in this slight sketch of his contributions to periodical works 
of science, I have been anticipating the course of his life, and must 
return to a period but shortly subsequent to the commencement of 
these labours. 

He had at that time considerably widened his social circle, had 
formed intimacies with many persons of distinction in science and 
in the common walks of life, had become favourably known in the 
community at large, and was rapidly extending his business as a 
practitioner of medicine. Only one thing was wanting to give 
permanence to his well-being, by affording a point towards which 
his thoughts and energies might ever tend, as the centre of his 
life. This want was supplied by his marriage, October 23, 1827, 
with Rebecca, daughter of Robert and Elizabeth Pearsall, highly 
respected members of the Society of Friends, originally of New 
York, but at that time residing in Philadelphia. This connection 
was, in all respects, a most happy one for Doctor Morton. He 
secured by it not only a devoted companion, who could appreciate, 
if not participate in, his pursuits, and lighten by sharing with him 
the burdens of life, but the blessing, also, of a loved and loving 
family, which gave unwearied exercise to his affections, and sus- 
tained a never-ceasing strain of grateful emotion, that mingled 
sweetly with the toils, anxieties, and successes of his professional 
career, and gave an otherwise unattainable charm to his intervals 
of leisure. 

It is reasonable to suppose that his professional business was 
increased by his marriage. That he possessed, in some measure, 
the confidence of the public as a practitioner, is shown by his ap- 
pointment, in the year 1829, as one of the physicians to the Phila- 
delphia Alms House Hospital. Here he enjoyed ample oppor- 
tunities for pathological investigations, of which he availed himself 
extensively, especially in relation to diseases of the chest, towards 
which his attention had been particularly directed by attendance 
on the clinical instructions of Laennec, during his stay in Paris. 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 445 

The fruit of these investigations will be seen in a work which will 
be more particularly noticed directly. 

In the year 1830, Dr. Morton added to his other duties those of 
a medical teacher. A brief notice of the association with which 
he was connected may not be amiss ; as it was one of the first of 
those organizations, now familiar to the profession in Philadelphia, 
in which a number of physicians unite, in order to extend to their 
private pupils advantages, which, separately, it would be impossible 
for them to bestow. It is quite unnecessary that I should speak of 
the benefits which have accrued from this plan of instruction to the 
profession in this city. Most of those who now hear me have, I 
presume, been taught under that system, and some are at this 
moment teachers. You can, therefore, appreciate its advantages ; 
but it is only the older among you who can do so fully, as it is 
only they who can compare it with the irregular and inefficient 
plan of private tuition that preceded it. Another incidental ad- 
vantage has been the training of a body of lecturers, from among 
whom the incorporated schools have been able to fill their vacant 
professorial chairs with tried and efficient men, and thus to sustain, 
amidst great competition, the old pre-eminence of Philadelphia as 
the seat of medical instruction. 

The late Dr. Joseph Parrish, from the increasing number of his 
office pupils, was induced to engage the services of a number of 
young medical men, to aid him, by lectures and examinations on 
the different branches of medicine, in the education of his class. 
This arrangement was in efficient operation for several years, but 
was at length superseded by another, in which all the teachers were 
placed on a footing of perfect equality; the private pupils of each 
one of them being received on the same terms, and those of other 
private teachers, not belonging to the association, being admitted 
on moderate and specified conditions. It was in January, 1830, 
that this little school was formed. In accordance with the simple 
tastes of its most prominent member, it took the modest name of 



446 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

"Philadelphia Association for Medical Instruction," a title which 
still survives in a highly respectable existing summer school, though 
the original association has long been dissolved. The first lectur- 
ers were the late Dr. Joseph Parrish on the practice of medicine, 
Dr. Franklin Bache on chemistry, Dr. John Rhea Barton on sur- 
gei'y, Dr. Morton on anatomy, and myself on materia medica. 
About the same time, another combination of the same character 
was formed, denominated, I believe, the "School of Medicine," in 
which Dr. C. D. Meigs taught midwifery. By an arrangement, 
mutually advantageous, the services of Drs. Bache and Meigs were 
interchanged; the pupils of the "Association" attending the lec- 
tures of the latter on midwifery, and those of the " School of Medi- 
cine" the chemical instructions of the former. Dr. Morton con- 
tinued to deliver annual courses on anatomy in this association for 
live or six years, when it was dissolved. His instructions were 
characterized by simplicity and clearness, without any attempt at 
display, and, so far as I have known, gave entire satisfaction both 
to his associates and pupils. 

On the 28th of November, 1831, he was chosen Corresponding 
Secretary of the Academy of Natural Sciences, and was thus 
brought into official communication with many scientific men in 
Europe and America. 

Reference was a short time since made to a work, based mainly 
upon his pathological investigations in the Alms House Hospital. 
It was denominated "Illustrations of Pulmonary Consumption," 
was printed in the early part of 1834, and contributed no little to 
the increase of his reputation as a practitioner. The work is an 
octavo of about 180 pages, treats of phthisis in all its relations, 
and is illustrated by several painted plates, executed with skill and 
accuracy. At that time little was known in this country of the 
admirable work of Louis on Consumption ; and the book of Dr. 
Morton no doubt contributed to the spread of sound views, both 
pathological and therapeutical, upon the subject. He particularly 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 447 

insists on the efficacy of exercise in the open air in the treatment 
of the disease, following in this respect in the footsteps of his pre- 
ceptor, Dr. Parrish, to whose memory great honour is due, for his 
successful efforts to revolutionize the previously vague and often 
destructive therapeutics in phthisis. 

Yery soon after the publication of this work, in the year 1834, 
Dr. Morton had an opportunity of making a voyage to the West 
Indies, as the companion and medical attendant of a wealthy in- 
valid. On this occasion he visited several of the islands, making- 
observations as he travelled in relation to their geological struc- 
ture, and at the same time investigating, with peculiar attention, 
the influence of their climate upon phthisis, and their relative fitness 
as places of resort for consumptive patients from colder regions. 

Some time after his return from the West Indies, he edited an, 
edition of Mackintosh's Principles of Pathology and Practice of 
Physic, adding explanatory notes, and making numerous additions 
to supply deficiencies in the original work. A second American 
edition was published in 1837, under his supervision. 

When it was that he began to turn his attention especially to 
ethnological studies I am unable to say; but it is probable that 
the idea of making a collection of human crania, especially those 
of the aboriginal races of this continent, both ancient and modern, 
originated soon after he entered into practice, if not even pre- 
viously ; and, among the earliest recollections of my visits to his 
office, is that of the skulls he had collected. It is well known to 
you that much of his time and thoughts, and not a little of his 
money, were expended in extending and completing this collection, 
in which he was also materially assisted by his own private friends, 
and the friends of science in general, who were glad to contribute 
their aid to so interesting an object. The cabinet thus commenced 
was gradually augmented, embracing the crania of the lower ani- 
mals as well as those of man, until at length it grew to a magnitude 
almost beyond precedent; and, at this moment, it forms one of the 



448 A MEMOIR OP DR. SAMUEL GEORGE MORTON. 

greatest boasts of our country in relation to natural science. It is 
ardently to be hoped that means may be found to secure its reten- 
tion here, and that it may ever continue to enrich the varied col- 
lections of our Academy, among which it has been deposited.* 

The possession of such materials naturally led to the wish to 
give diffusion and permanence to the knowledge which they laid 
open. Hence originated Dr. Morton's great work on American 
Crania, in which accurate pictorial representations are given of a 
great number of the skulls of the aborigines of this continent, with 
descriptions, historical notices, and various scientific observations ; 
all preceded by an essay on the varieties of the human species, cal- 
culated to give consistency to the necessarily desultory statements 
which follow. The preparation of this work cost the author a vast 
deal of labour, and an amount of pecuniary expenditure which has 
never been repaid, unless by the reputation which it gained for him, 
and the consciousness of having erected a monument to science, 
honourable to his country, and likely to remain as a durable memo- 
rial of his own zeal, industry, and scientific attainment. It was 
published in 1839. It is due to Dr. W. S. W. Ruschenberger to 
state, that the work was inscribed to him by Dr. Morton, with the 
acknowledgment that some of its most valuable materials were 
derived from his researches in Peru. 

In September, 1839, Dr. Morton was elected Professor of Ana- 
tomy in the Pennsylvania Medical College, the duties of which 
office he performed until November, 1843, when he resigned. In 

* I have been informed, on the very best authority, that, independently 
of all the assistance in making this collection afforded by others, it cost 
Dr. Morton somewhere between ten thousand and fifteen thousand dollars. 
Through the contributions of a number of gentlemen, interested in the scien- 
tific reputation of our city, this collection was secured for the Academy, and 
now forms a portion of its invaluable museum. It is due to the heirs of 
Dr. Morton to state, that the sum received for the collection bore but a small 
proportion to that expended in its formation. 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 449 

that institution he was associated with the late Dr. George McClel- 
lan, who may be looked on as its founder, and for whom he formed 
a friendship which ended only with life. 

On the 26th of May, 1840, he was elected one of the Vice-Pre- 
sidents of the Academy of Natural Sciences, in which capacity he 
very often presided at its meetings, in the absence of the President. 

He was engaged about this time in preparing a highly interest- 
ing memoir on the subject of Egyptian Ethnography, based mainly 
upon the observation and comparison of numerous crania, in the 
collection of which he was much aided by Mr. George R. Gliddon, 
whose residence in Egypt gave him opportunities, which an ex- 
traordinary zeal, in all that concerns the ancient inhabitants of that 
region, urged him to employ to the best possible advantage. This 
memoir was embraced in several communications to the American 
Philosophical Society, in the years 1842 and 1843, which were pub- 
lished in the Transactions of that Society (Vol. ix., New Series, 
p. 93, a.d. 1844), and also in a separate form, under the title of 
" Crania Egyptiaca, or Observations on Egyptian Ethnogra- 
phy," with handsomely executed drawings of numerous skulls, de- 
rived from the pyramid of Saccara, the necropolis of Memphis, the 
catacombs of Thebes, and other depositories of the ancient dead in 
that region of tombs. 

In January, 1845, Dr. Morton was elected a Fellow of this Col- 
lege. That we did not more frequently see him among us, was 
probably owing to the unfortunate coincidence, at that time exist- 
ing, of the meetings of the College and Academy, which would 
have rendered necessary a neglect of his official duties in the latter 
institution, had he attended at the sittings of the former. It may 
be proper here to mention, though not in strict chronological 
order, that, by the appointment of the College, he prepared a brief 
biographical sketch of Dr. George McClellan, which was read in 
September, 1849, and published in the Transactions of that date. 



450 A MEMOIR OF Dlt. SAMUEL GEORGE MORTON. 

In the years 1846 and 1847, he prepared essays " On the Eth- 
nography and Archaeology of the American Aborigines" and 
"On the Hybridity of Animals and Plants in Reference to the 
Unity of the Human Species," which were read before the Aca- 
demy, and afterwards published in the American Journal of 
Science and Arts (III., 2d ser., a.d. 1847). In these papers he 
advanced opinions upon the origin of the human family, which led 
to an unfortunate controversy, that, with his delicacy of feeling, 
could not but have in some measure disturbed the tranquillity of 
the latter years of his life. It is due to Dr. Morton to say that 
he did not consider the views, advocated by himself, as conflicting 
with the testimony of Scripture, or in any degree tending to in- 
validate the truths of revealed religion. 

During the year 1848, much of his time was devoted to the pre- 
paration of an elementary work on "Human Anatomy, Special, 
General, and Microscopic," illustrated by a great number of 
figures, and aiming to be an exposition of the science in its present 
improved state. Among his inducements to this work, not the 
least, as he states in the preface, was the desire to be enrolled 
among the expositors of a science that had occupied many of the 
best years of his life. Though laying no claim to originality in its 
facts or illustrations, the treatise cost him a great deal of labour, 
not only in the arrangement of the matter, the care of the en- 
gravings, and the superintendence of the press, but also in the 
verification, by microscopic observation, of the accuracy of the pic- 
torial representations of minute structure in which it abounds. It 
was issued from the press early in 1849; but, even before its pub- 
lication, he had begun to feel the effects upon his health, never 
robust, of the toilsome task he had undertaken, in addition to pro- 
fessional and official engagements, which alone would have been 
sufficient for the wholesome employment of his time and energies. 

Scarcely had his last duties in connection with this work on 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 451 

Anatomy been performed, when, in December, 1848, he was at- 
tacked with a severe pleurisy and pericarditis, which brought him 
into the most imminent danger of life, and from the effects of which 
he never fully recovered ; for though, after a long confinement, he 
was enabled to go about, and even to resume his professional 
duties, he was left with great and permanent derangement of his 
thoracic organs. 

The very obvious depression of his left shoulder, and the falling 
in of the corresponding side of the chest evinced, at a glance, that 
with the absorption of the pleuritic effusion the lung had not ex- 
panded; and the loud murmur, obvious upon auscultation over the 
heart, proved to his professional friends that this organ had not 
escaped without serious injury. Notwithstanding, however, the 
amount of local derangement, his system rallied; and, after an ab- 
sence of some weeks from the city, he returned so much improved 
in health and strength, that he felt himself authorized to resume 
his active professional avocations, and general previous course of 
life, though with some abatement of his labours in the fields of 
original investigation and of authorship. 

Could his sense of duty, at this period, and the disposition to 
strong mental activity, which had probably become by habit almost 
a necessity of his nature, have permitted him to withdraw from all 
vigorous exertion, and to devote his time for the future rather to 
quiet enjoyment than to laborious effort, it is not impossible thas 
his life might have been considerably prolonged. Such was the 
advice of some of his medical friends ; but stronger influences im- 
pelled him to exertion ; and, like most men who feel themselvet 
irresistibly drawn into a certain course of action, he succeeded in 
reconciling this course- not only to his general sense of duty, but 
even to his views of what was required under the particular cir- 
cumstances of his health. He was convinced that, by active bodily 
exertion, he should be most likely to bring his defective lung back 



452 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

again to the performance of its function ; and certainly, for a time, 
his improving appearance and increasing strength under exercise 
seemed to justify the system he had adopted. 

Before adverting to the closing scene, let us stop, for a very few- 
minutes, to take a view of his character and position at this period, 
which, if the consideration of his health be omitted, was the most 
prosperous of his life. 

His election to the presidency of the Academy of Natural 
Sciences, which took place December 25, 1849, had given him an 
official position than which he could not expect to gain one more 
honourable, and than which society in this country have few more 
honourable to bestow. Of an amiable and benevolent temper, in- 
disposed to give offence, or to wound the sensibilities of others, he 
had conciliated general good-will; while his affectionate disposi- 
tion, his deep interest in those to whom he was attached, and his 
readiness to serve, secured him warm friends, especially in the 
circle of his patients, who in general had much regard for him 
personally, as well as great trust in his skill. Powers of quick 
and accurate observation, and a sound cautious judgment were 
perhaps his most striking intellectual characteristics, and naturally 
led him into those departments of science where they could be most 
efficiently exercised. 

By strict attention to his professional duties, even in the midst of 
his scientific researches, by an affectionate interest in his patients, 
inspiring similar sentiments on their part, and by a system of cau- 
tious but successful therapeutics, he gained a large, and for Phila- 
delphia, a lucrative practice, which, with some income derived by 
inheritance from an uncle in Ireland, enabled him to live hand- 
somely, and not only to entertain his scientific friends and asso- 
ciates on frequent occasions at his house, but also to extend hospi- 
talities to strangers, whom his reputation attracted towards him 
upon their visits to our city. His friends will not soon forget the 



A MEMOIR OF DR. SAMUEL GEORGE MORTON. 453 

weekly soirees, at which they enjoyed the pleasure of combined 
social and scientific intercourse, and had the frequent opportunity 
of meeting strangers, distinguished in the various departments of 
learning and philosophy. 

His extensive professional relations, and his reputation both as 
a practitioner and teacher of medicine, attracted to his office many 
young men disposed to enter into the profession ; and he usually 
had under his charge, towards the close of his life, a considerable 
number of private pupils, to whom he devoted much time, and his 
most conscientious endeavours to qualify them to be good physi- 
cians. 

Numerous learned and scientific associations in different parts of 
America and Europe had enrolled him among their members; and 
perhaps few men in this country had a more extensive correspond- 
ence with distinguished individuals abroad.* To be praised by 
the praised is certainly a great honour ; and this Dr. Morton was 
happy enough to have won in no stinted measure. 

With these meritorious qualities, these well-earned distinctions, 
and these diversified sources of comfort and enjoyment, with the 
crowning pleasures, moreover, of domestic confidence and affection, 
and bright hopes for a rising family, our late friend and fellow- 
member may be considered, at this period of his life, as one of the 
most happy of men in all his exterior relations. The only draw- 
back was the uncertain state of his health. 

From early manhood he had been of delicate constitution. Two 
attacks of severe haematemesis had on different occasions threat- 
ened his life ; and for a long time he suffered much with excruciat- 
ing attacks of sick headache, which most painfully interrupted his 
scientific and professional avocations, and not unfrequently con- 

* For a list of the societies of which lie was a member, see the Appendix 
to Dr. Meigs's Memoir. 



454 A MEMOIR OF DR. SAMUEL GEORGE MORTON. 

fined him for a time to his bed. For many years of his earlier life, 
his pale complexion and spare form indicated habitually feeble 
health; but at a more advanced period he seemed to have greatly 
improved in this respect, exhibiting a more healthful colour and 
more robustness of frame ; and, but for the terrible attack which 
prostrated him in the winter of 1848-49, there seemed to be no 
reason why he should not live to a good old age. But the fiat 
had gone forth ; and, though a respite was granted, it was des- 
tined to be short. 

A painful incident, which happened about this time, may possibly 
have had some effect in aggravating the morbid tendencies, already 
unhappily strong. I refer to the illness and speedy death, in May, 
1850, of an affectionate, dearly loved, and highly promising son, 
to whose future he was looking forward with much, and appa- 
rently well-founded, confidence. 

Perhaps at no time was Dr. Morton more busily occupied in 
practical duties than during the year or two which preceded his 
death. He was indefatigable in attendance upon his numerous 
patients, devoted no little time to the instruction of his private 
pupils, and never voluntarily omitted the performance of his aca- 
demic functions. In the midst of this career of usefulness, he was 
seized with an illness, which, commencing on the 10th of May 
with a moderate headache, became more severe on the following 
day, and, though afterwards relaxing so much as to give hopes of 
a return to his ordinary health, ended in an attack of stupor and 
paralysis, which proved fatal on the 15th, the very day upon which, 
one year previously, he had witnessed the death of his son. 

Dr. Morton was considerably above the medium height, of a 
large frame, though somewhat stooping, with a fine oval face, pro- 
minent features, bluish-gray eyes, light hair, and a very fair com- 
plexion. His countenance usually wore a serious and thoughtful 
expression, but was often pleasingly lighted up with smiles, during 



A MEMOIR OP DR. SAMUEL GEORGE MORTON. 455 

the relaxation of social and friendly intercourse. His manner was 
composed and quiet, but always courteous, and his whole deport- 
ment that of a refined and cultivated gentleman. 

He left behind him a widow and seven children, five sons and 
two daughters, several of whom have advanced to adult age, and 
are engaged in active life. In the remembrance of the virtues, the 
attainments, the fruitful labours, and the well-earned reputation of 
the husband and father, they have a legacy far more precious than 
the gifts of fortune ; an inheritance which no mischances of this 
world can impair, and which will be handed down as a priceless 
heirloom to their latest posterity. 



INDEX. 



Abuses of the Materia Medica... 124 

Address at the Medical Com- 
mencement in April, 1841 352 

Address at the Medical Com- 
mencement in March, 1836 331 

Address at the Medical Com- 
mencement in March, 1856 370 

Addresses, Pharmaceutical 1 

Addresses to Medical Graduates.. 329 

Address to the Graduates of the 
Philadelphia College of Phar- 
macy 30 

Addresses to the Medical Grad- 
uates of the University of 
Pennsylvania 327 

Address to the Members of the 
Philadelphia College of Phar- 
macy 3 

Allopathy and Allopathists, im- 
propriety of the names 252 

American Colleges of Pharmacy 99 

American Journals of Pharmacy 95 

Amphitheatre of the Hospitals at 
Paris 308 

Animal Magnetism, as a Remedial 
Agent 161 

Apothecaries in England 259, 284 

Apothecary, Standard of Attain- 
ment and Character of the.... 5 

Arabian Writers on Materia Me- 
dica 61 

Association for Medical Instruc- 
tion, Philadelphia 403, 446 

Authors on Materia Medica, Ame- 
rican.... 86,93 

Authors on Materia Medica, mod- 
ern 73 



30 



PAGE 

Bache, Franklin, M.D.. 30,93,301,446 
Bachelor of Medicine, Degree of, 
in the University of Pennsyl- 
vania 344 

Barton, Benjamin Smith, M.D. 86,194 

Barton, John Ehea, M.D 446 

Barton, Win. P. C , M.D 89 

Bartram, John 85 

Basil Valentine 64 

Beck, John B., M.D 94 

Beck, Lewis C, M.D 94 

Bell, John, M.D 93, 94 

Biddle, John B., M.D 94 

Bigelow, Jacob, M.D 89 

Biographical Memoirs 385 

Bond, Dr. Thomas 335 

Broussais 110, 260 

Brown, Dr 110 

Carson, Joseph, M.D 94, 95 

Celsus, Writings of 68 

Chapman, Nathaniel, M.D., 
sketch of the character and 

life of. 208 

Chapman's Therapeutics and Ma- 
teria Medica 92 

Character and Objects of the 

Medical Profession 230 

Chemists, Sect of the 64 

Choice of Medicines 160 

Christison, Dr 282 

Clayton, Dr. John 85 

Clinical Instruction, Importance 

of 225 

Clinical Instruction in Europe.... 307 

Colden, Dr. Cadwallader 85 

College of Physicians of Phila- 
delphia 28 

(457) 



458 



INDEX. 



Colleges of Pharmacy, American 99 
Continent of Europe, Medical 

Profession in the 300 

Coxe, John Redman, M.D 92 

Death, in what manner to be 

viewed 381 

Degree in Pharmacy, Importance 

of establishing 15 

Demonstrative Teaching, Import- 
ance of 222 

Dewees, Dr.Wm. P 342 

Dioscorides, Writings of 59 

Dogmatists. Sect of the 56 

Dorsey, John Syng, M.D 341 

Dunglison, Robley, M.D 93,94 

Eberle's Materia Medica and 

Therapeutics 93 

Efficiency of Medicine 266 

Ellis, Benjamin, M.D 30, 93 

Elmer, Jonathan, M.D 336 

Elmer, William, M.D 336 

Emotions as Remedies 149 

Empiricism 138, 186, 367 

Empirics, Sect of the 56 

European Continent, Medical 

Profession on the 300 

European Schools of Medicine.... 304 
European Writers on Materia 

Medica, modern 73 

Examinations, Importance of, in 

Medical Instruction 222 

Examinations in the Medical 

Schools of Europe 310 

Faith as a Remedy 155 

False Theory, Influence of, in the 

Use of Medicines 130 

Fashion, Influence of, in the Use 

of Medicines 129 

Feelings as Remedies 149 

Frost, Henry R., M.D 94 

Galenists Sect of the 64 

Galen, Writings of 59 

General Practitioners in England 284 
Gerhard, Wm. W., M.D 423 



PAGE 

Germany, Medical Schools of 305 

Graduates, Annual Number of, in 
the Medical Department of the 

University of Pa 343, 344 

Graduates of the Philadelphia 
College of Pharmacy, Address 

to the 30 

Great Britain, Medical Profes- 
sion in 275 

Griffith, R. Egglesfeld, M.D 94, 95 

Griffitts, Samuel Powell, M.D 393 

Hare, Robert, M.D 180 

Harlan, Richard, M.D 440 

Harrison, John P., M.D 94 

Hippocrates, Writings of 55 

History of Materia Medica 53 

History of Materia Medica in the 

United States 76 

History of the Medical Depart- 
ment of the University of Pa.... 331 

Hodge, H. L., M.D 210 

Homoeopathy and homceopathists, 

132, 252, 260 

Hooker, Worthington, M.D 94 

Hope as a Remedy 153 

Horner, Wm. E., M.D 210, 321 

Hospitals as Schools of Medicine 

in Europe 292, 307 

Hospitals in Europe 313 

Imagination as a Therapeutic 

Agent 158 

Imperfection of Medicine 257 

Imperial Medico -Chirurgical 

Academy of St. Petersburg.... 318 
Importance of Materia Medica... 105 
Importance of the Practice of 

Medicine 214 

Intellectual Faculties, Remedial 

Influence of the 157 

Introductory Lectures on Ma- 
teria Medica 51 

Introductory Lectures to the 
Course on the Theory and 
Practice of Medicine 191 



INDEX. 



459 



PAGE 

Ireland, Medical Instruction and 

Profession in 296 

Isaac of Holland 64 

Jackson, Samuel, M.D... .12, 210, 321 
Journals of Pharmacy, American 95 

Journey in Europe 301 

Kuhn, Dr. Adam 335 

Lectures, Advantages of. 121 

Lectures Introductory to the 
Course on Materia Medica in 
the University of Pennsyl- 
vania 49 

Lectures Introductory to the 
Course on the Theory and 

Practice of Medicine 189 

Lectures on the Theory and 
Practice of Medicine, plan of.. 206 

Lee, Charles A., M.D 94 

McClellan, George, M.D 449 

Maryland College of Pharmacy./ 95 
Materia Medica, Abuses of the.. 124 
Materia Medica, American Wri- 
ters on 85, 93 

Materia Medica, History of 53 

Materia Medica, History of in 

the United States 76 

Materia Medica, Importance of.. 105 
Materia Medica, modern Euro- 
pean Writers on 73 

Medical Department of the Uni- 
versity of Pennsylvania, His- 
tory of the.... 331 

Medical Education in Russia 318 

Medical Education on the Conti- 
nent of Europe 304 

Medical Instruction, Philadel- 
phia Association for 403, 446 

Medical Profession, Character 

and Objects of the 230 

Medical Profession in Great Bri- 
tain, Lecture on the 275 

Medical Profession on the Conti- 
nent of Europe, Lecture on 
the 300 



PAOE 

Medical Schools in England 291 

Medicines of American Origin... 77 

Meigs, Charles D., M.D 435, 446. 

Memoir of Dr. Joseph Parrish.... 387 
Memoir of Dr. Samuel George 

Morton 435 

Memoirs, Biographical 385 

Mental Agency in the Treatment 

of Disease 145 

Mercenary Spirit in the Medical 

Profession, effects of 234 

Mesmerism as a Remedial Agent 161 

Michaux the Elder 87,88 

Michaux the Younger 88 

Mitchell, John K., M.D 164, 210 

Mitchell, Thos. D., M.D 94 

Moral Remedies 148 

Morgan, Dr. John 334 

Morton, Samuel George, M.D., 

Memoir of. .'. 435 

New York College of Pharmacy.. 99 
Novelty, Influence of, in the 

Choice of Medicines 176 

Novelty, Influence of, in the Use 

of Medicines 129 

Otto, John C, M.D 429 

Paine, Martyn, M.D 94 

Paracelsus 64 

Parrish, Dr. Joseph, Memoir of.. 387 

Parrish, Edward 94 

Passions as Remedies 149 

Pereira, Dr 282 

Pharmaceutical Addresses 1 

Pharmacopoeia of the Medical 

Society of Massachusetts 97 

Pharmacopoeia of the United 

States 27, 98, 169 

Pharmacopoeias, British 97 

Pharmacy, State of the Profes- 
sion of 33 

Philadelphia as a Seat of Medi- 
cal Instruction 345 

Philadelphia Association for Me- 
dical Instruction 403, 446 



460 



INDEX. 



PAGE 

Philadelphia College of Phar- 
macy 3, 11 

Physicians and Surgeons of the 

Continent of Europe 315 

Physicians in England 277 

Physick, Dr. Philip Syng, Notice 

of 340 

Pliny, Natural History of 59 

Polished Manner, Importance of, 

to the Physician 245 

Poplar Worm 395 

Practice of Medicine, Import- 
ance of 214 

Practice of Medicine, not a Par- 
ticular System 251 

■ Practice of Medicine, Scope of.... 251 

Procter, Prof. Wm., Jr 95 

Professional Secrecy 249 

Professional Spirit, Importance 

of ." 357 

Profession of Medicine, Influ- 
ence of, on its Members 363 

Professions of Medicine and 
Pharmacy, Separation of the, 20, 35 

Pursh, Frederick 88 

Quackery 138, 186, 367 

Qualifications of a Physician 358 

Ruschenberger, W. S. W., M.D. 448 

Rush, Dr. Benjamin 110, 260, 336 

Russia, Medical Profession and 

Schools in 318 

Schools of Medicine, European.. 304 
Scope of the Practice of Medi- 
cine 251 

Scotland, Medical Instruction and 

Profession in 296 

Scribonius Largus, Writings of... 58 

Secrecy, Professional 249 

Secret Medicines.... 184 

Sessions, Length of, in Medical 

Schools 204 

Shippen, Dr. William 334 

Shoepf, Dr 86 

Skepticism in Medicine 265 



PAGE 

Smith, Daniel B 37 

Somnambulism 161 

Sordid Views in a Physician, 

Tendencies of. 234 

Spontaneous Curability of Dis- 
eases 261 

Stille, Alfred, M.D 94 

Studies after Graduation 354 

Study as distinguished from 

Reading 218 

Study of Medicine, Requisites in 

the 213 

Study of the Theory and Prac- 
tice of Medicine 221 

Surgeons in England 282 

Term of Study in the Schools, 

Extent of the 204 

Thatcher, James, M.D 92 

Theory and Practice of Medi- 
cine, Extent of, as a Branch 

of Study 196 

Theory and Practice of Medicine, 

Importance of 197 

Theory and Practice of Medicine, 

Introductory Lectures to 191 

Theory in Medicine 256 

Therapeutics and Pharmacology, 

Treatise on, by the Author 94 

Tully, William, M.D 90, 94 

Typhous Epidemic of 1812-13... 398 

United States Dispensatory 93 

University of Pennsylvania, His- 
tory of the Medical Depart- 
ment of the 331 

Van Helmont 64 

Wistar, Dr. Caspar, Notice of, 

339, 411, 413 
Writers on Materia Medica, Ame- 
rican 86, 93 

Writers on Materia Medica. mo- 
dern 73 

Wylie, Sir James, Sketch of the 
Life of 320 



W,T.in igtyi 



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